The Assembly met at 13:30 with the Llywydd (Elin Jones) in the Chair.

I call Members to order.

1. Questions to the Minister for Economy and Transport

The first item on our agenda this afternoon is questions to the Minister for Economy and Transport, and I have received notification under Standing Order 12.58 that the Deputy Minister for Economy and Transport, Lee Waters, will answer questions on behalf of the Minister this afternoon. Therefore, the first question is from David Rees.

Welsh Steelworkers

David Rees AC: 1. What action is the Welsh Government taking to protect the jobs of Welsh steelworkers? OAQ54632

Lee Waters AC: Thank you. The Welsh Government continues to take a cross-Government approach to support the steel industry and protect the jobs of Welsh steelworkers. We have, over the last three years, provided significant investment to support the industry in key areas, including skills development, environmental improvements, and research and development.

David Rees AC: Thank you for that answer, Deputy Minister. Unlike the UK Government, which has failed to do anything on behalf of steel, and, I understand, even cancelled the latest steel council meeting, which was crucial because there's not one been held for 18 months, and they still haven't got one going—. They've also failed to actually produce an industrial strategy for the steel sector, and they've not even looked at tackling the issues of the equal playing field, particularly in energy costs, that we will need to have when we face a competitive global market in the steel sector.
I know that the Welsh Government, as you quite rightly pointed out, has been very active in supporting this industry and has been at the forefront, particularly for Welsh steelmakers, to ensure that steel stays at the heart of the Welsh industrial strategy. Can you answer as to whether the conditionality that the Welsh Government has put on some of that financial support to the works at Port Talbot, particularly in relation to the £30 million that was allocated to the Port Talbot works for the power plants, has been met, because the release of that money will allow the next stage of the power plant to progress, including, therefore, better use of waste gas, improvements in environmental standards, and more efficient and effective production, and lower cost because they're producing their own electricity rather than having to buy it off the grid at high costs that the UK Government are not addressing?

Lee Waters AC: Thank you. I think David Rees has very well summarised there the state of play with the UK Government's absence of leadership on steel and the cancellation of the steel council meeting. We continue to be in close contact with Tata, as we have done for many years. As you noted, in the 2016 steel crisis, we provided £10 million skills funding towards an offer of £12 million towards the development of the workforce of Tata Steel. We've also offered some £666,000 for research and development into new product development.
In terms of the power plant, we have offered £8 million investment to date, but with the exception of the skills funding, Tata is unable to draw down the funding against these offers until we've agreed the conditions of funding. And, following the announcement in May that the proposed joint venture with Thyssenkrupp would not be going ahead, Tata Steel is now working on a new transformation plan for the company. And in light of these changes, we continue our engagement with the company, including discussions on potential support for the power plant.

Mark Isherwood AC: As you are aware, Tata Steel in Shotton is a dynamic business and major exporter, but dependent upon the supply chain for sustainable British steel, and on feedstock from the heavy end in south Wales. On Monday, I received an e-mail, as did other Members representing the area, from Heathrow Airport, announcing that they're one of the 18 shortlisted Heathrow logistic hub sites, inviting them to formally enter the tender process for the Heathrow expansion. In response, your colleague the Minister for the Economy and Transport said he looked forward to continuing Welsh Government's work with the site promoters and the Heathrow team in this selection process. What will the Welsh Government therefore be doing in that context to support Tata, as well as the port in Cardiff—the other shortlisted Welsh bidder—to maximise the opportunities presented by this?

Lee Waters AC: Well, it's excellent news that they've got through to the next round, and we've supported them all along the way, so we'll continue to offer that support to them. This is an investment that we welcome. If there is going to be this large infrastructure scheme in London, it's only fair that the benefits spread across the UK.

John Griffiths AC: Minister, the Orb steelworks in Newport should continue in operation, and, with the right level of support from Tata Steel, UK Government and Welsh Government, it would be enabled to produce electrical steels for electric car production in the future. There's a very strong local campaign to keep the Orb works in production, and, indeed, it's been a feature of economic life in Newport since the end of the nineteenth century. Could you reiterate the Welsh Government's support for that, and would you welcome a campaign launched today by theSouth Wales Argus, which has launched a petition in support of retaining that Orb steelworks plant?

Lee Waters AC: Well, I can be very clear to John Griffiths that the Welsh Government does not want the Orb steelworks to close. We've been in discussion with Tata and with Community Union to see what can be done. Tata has continued to state the case that the plant is making substantial losses and there is oversupply in the world market, and they don't feel that there is a viable future. Now, Community Union have commissioned consultants themselves—Sindex—to explore alternatives to closure for Orb, and have created an outline proposal, which indicates that, with Welsh Government funding and a range of other changes by the company, a viable future is possible. We've received a summary of that proposal, and we'll need to understand the detail of it and Tata Steel's response to the recommendations. The First Minister will be meeting Community Union to discuss the proposal, and we'll be making sure that we properly understand what role we can play to give this a viable future.

The A4042 Trunk Road at Llanellen

Nick Ramsay AC: 2. Will the Minister provide an update on measures to improve the A4042 trunk road at Llanellen? OAQ54622

Lee Waters AC: Well, there are no immediate plans to improve the A4042 trunk road at Llanellen. The Welsh Government, however, does routinely monitor the performance of the trunk road network.

Nick Ramsay AC: Thank you for that answer, Minister. You will no doubt be aware—or certainly your colleague Ken Skates is aware—of ongoing issues with flooding on the A4042 at Llanellen, particularly at this time of year. The road was closed again during the recent bad weather, causing traffic chaos for commuters. I'm particularly concerned that this route is going to be even more critical when accident and emergency, and other services, transfer from Nevill Hall to the new Grange University Hospital in Cwmbran, when also people from Brecon and Radnorshire and the south of Powys will be dependent on the new hospital as well, as this really could become a matter of life and death with increased journey times. I wonder if you could update us, or set in chain circumstances to update us, on improvements to this stretch of road, whether that be improved drainage, raising the road, or possibly, and probably best in the medium term, or longer term at least, a bypass for the village of Llanellen.

Lee Waters AC: Well, as Nick Ramsay knows, this has been a problem for some 20 years or so and there is no simple solution to it. We are acutely aware of the problem and have spent some time investigating potential solutions. He will know that the existing bridge is a grade II listed structure, that it is next to a flood plain, and there is no simple engineering solution that would respect its existing characteristics or do the job within the existing footprint. We are doing what we can, working with local landowners, to maintain the land, to drain the ditches, and the delays when the road is closed are now becoming significantly lessened. There have been occasions when the road has been closed for a week, and I believe the most recent closure was for an hour. So, we are doing a lot to try and mitigate; we can't simply solve it. We are, of course, investing in rail, and the Chepstow service, which currently only gets two trains an hour, will increase capacity from mid December to four trains an hour. So, that's another intervention we're making to help with the situation. But if there's an easy and simple solution the Member has in mind we haven't considered, we'd certainly be willing to look at it.

Questions Without Notice from Party Spokespeople

Questions now from the party spokespeople. The Plaid Cymru spokesperson, Rhun ap Iorwerth.

Rhun ap Iorwerth AC: Diolch yn fawr iawn, Llywydd. One of the last things that Alun Cairns did as Secretary of State for Wales—or the Secretary of State for the west of England, as he had become to be known by many—was to establish the western gateway. Where is the western gateway a gateway to, and for whom?

Lee Waters AC: Well can I first say that, obviously, Alun Cairns has resigned in the last couple of hours, and I think that was the right thing to do in the circumstances? Clearly, our Government and his Government have had significant differences over a number of issues. But I should say that both Ken Skates and myself have had cordial and professional relationships with Alun Cairns, and, especially on the city deals, we've worked well together, and we certainly wouldn't have wished his time as a Minister to come to an end in this way.
On the question directly posed, it's most unfortunate that the Severnside collaboration has been called 'west Britain' in some of its social media activity. Certainly, that's not designed to get it off to a good start. We are keen, obviously, to look at a forum that can collaborate across the border, just as we do in north Wales with the Mersey Dee Alliance. However, we are sceptical about the intentions behind the setting up of this alliance and giving it, certainly, any institutional character because we fear the UK Government are using this as a Trojan horse to undermine the Welsh Government through whatever comes of the shared prosperity fund. We look forward to seeing if anything comes of the shared prosperity fund. But we are approaching it, I think, with scepticism. The chair that's been appointed, Katherine Bennett, is a very good person and we certainly wouldn't wish to undermine her in any way. This is not a joint appointment, but we certainly would like a conversation with her about how she feels this alliance goes forward, with our concerns in mind.

Rhun ap Iorwerth AC: Well, Welsh Government, of course, is hailed as a partner in the western gateway project. Within minutes of the launching of the project, the chair that you mentioned referred to 'the powerhouse of the west of Britain'. How do you think that rebranding of Wales as the west of Britain or a part of the west of Britain helps with the work that needs to be done to build a genuine Welsh economy that can then work in genuine partnership with our friends to the east?

Lee Waters AC: Well, I happened to speak to Katherine Bennett on the morning that tweet went out and she made clear to me that those were not her words. I suspect the hyperactive office of the aforementioned previous Secretary of State may have had a hand in that, but, I think, putting that to one side, there remains an economic geography there that we want to explore and exploit, but we are a devolved Government, we have a boundary to respect, and we certainly are not going to be naive about the political agendas at play in Westminster around this, but we do want what's best for the people of that part of Wales and our closest neighbours.

Rhun ap Iorwerth AC: 'We remain sceptical', I don't think is good enough when it comes to some of the messaging that I have certainly heard and read around the western gateway project. What we want to see is a Welsh Government that genuinely builds a Welsh economy, and I fear that Welsh Government has been taken for a ride by the Wales Office under Alun Cairns. The Welsh Government has been far too keen, I think, to hang on to the coat-tails of Alun Cairns as Secretary of State for Wales. We know that Welsh Government agreed on the nod to the renaming of the second Severn crossing as the Prince of Wales Bridge, which we know went down like a lead balloon with people in Wales. We know that Welsh Government did have an opportunity to have its say on that issue and decided, for whatever reason, not to, and I fear that when it comes to the western gateway, as well as projects across the border between the north-east of Wales and the north-west of England, that Welsh Government isn't taking its role seriously enough in creating a genuinely strong Welsh economy.
I am a big supporter of cross-border working. Cross-border working works to the mutual benefit of neighbouring countries and regions globally. That is no different for us in Wales. But will the Minister see that as long as we have an impression of a Welsh Government that is going with a begging bowl to those partnership meetings, that doesn't seem to want to be there as a genuine partner, Wales will be undersold by this Welsh Government?

Lee Waters AC: Well, I think that's a little overexcited. I think I would struggle with—[Interruption.]

Rhun ap Iorwerth AC: I'd like you to get a bit more excited about making use of the Welsh economy. Get excited about—

Lee Waters AC: And I think I would struggle—. I would struggle—[Interruption.] With respect, you've asked your question. Your question is finished. I'm trying to answer it, if you will allow me to.

Rhun ap Iorwerth AC: Well, no, there was a snide remark. That's what I heard first.

Lee Waters AC: Well, with respect—

Allow the Minister to carry on with answering your question.

Lee Waters AC: Rhun ap Iorwerth is offended I made a snide remark. He's accused us of having a begging-bowl attitude, so that's pretty snide, I would say, in respect, to that.
And in terms of Alun Cairns' coat-tails, I'd struggle to reach them, with respect. So, there's no subservient attitude here and I think it doesn't help a calm discussion about how we can advance the economic interests of south Wales to dress it up in such hysterical language.
As I've made clear, the term of 'west Britain' was certainly not ours and it wasn't, indeed, even the chair's, and I certainly would not—and I was clear in my earlier answer—endorse that. As I've said, we're not naive about the political agendas here at play. This was not a joint appointment. This is not something we are jointly setting up. The UK Government have taken this initiative. We'll watch it with interest. If it is a forum for sharing information, we'd be happy to be part of it. If it's any more than that, we will not.

Conservative spokesperson, Russell George.

Russell George AC: Diolch, Llywydd. Deputy Minister, has the timetable for the South East Wales Transport Commission slipped?

Lee Waters AC: Not to my knowledge.

Russell George AC: Thank you. That's good to hear. In June of this year, Deputy Minister, your boss, the Minister, said to this Chamber that transport is an area where the Welsh Government has ambitious plans for the future. He said he expected an interim report for the South East Wales Transport Commission within six months. The Minister also said, and I'm quoting here:
'I've been very keen and clear in saying to the chair and to the public that if the commission is able to bring forward viable suggestions that can be delivered'
in the short term, within the next six-month period, to ease congestion on the M4, they should be done so without delay.
Since these statements back in June, can I ask a couple of questions? Can I ask why it has taken until October to establish the membership of the commission? And can I also ask: can you confirm that, by the end of this year, we will have the interim report, or will it just be an update? And can I ask, what appears to be kicking into the long grass—can you tell me if this interim report has been kicked into the long grass, or do you still anticipate the report to be delivered by the end of this year?

Lee Waters AC: Both the First Minister and the economy Minister made it very clear to the chair of the commission that we expect to have early recommendations by Christmas, and that remains our expectation.
There has been some time taken to assemble a very high calibre panel of people. They've published their terms of reference and their way of working. I'm very encouraged that they are not going to be constrained, in the way that previous studies have, to simply look at road options, but will look at the full array of interventions, including behaviour change, to tackle the congestion and the car dependency in that part of Wales, and not simply the traditional approaches that have dominated this debate for many years.
So, I fully expect an exciting range of proposals, with some initial thoughts by the end of this year.

Russell George AC: Thank you, Minister. You'll also be aware that the volume of traffic on the M4 is increasing day by day. We've had a new poll, which shows that almost twice as many people in Wales now believe that the M4 relief road should be built, contradicting the view of the First Minister and the Welsh Government. But can you confirm whether or not the option of building the M4 relief road is, or isn't, within the scope of the South East Wales Transport Commission's terms of reference? And, if so, and they recommend to you to go ahead and build it, will you do that or will you reject the findings of this independent commission?

Lee Waters AC: No. Having gone through a public inquiry that looked at the black route, there'd be absolutely no point in setting up another inquiry to go and re-examine the exact same option. So, that is not an option that the commission is looking at. They're looking at alternatives, which we believe can be delivered quicker and cheaper to better effect than the road that was previously examined.
Russell George mentions a poll that was published yesterday, which—. Well, I'd say two things about that: first of all, the First Minister made his decision not because it was popular but because it was the right thing to do, because the inspector's report did not take proper recognition of the climate emergency nor the collapse in biodiversity. That was a principled decision the Government took, not one chasing popular headlines. And the poll, really, isn't worth a great deal, when you think about the way it was framed. Had the question been framed to say to people, 'Would you be willing for your hospital and your school to be cancelled for a project that's more than doubled in budget?', it might have produced a different result.

Brexit Party spokesperson, David Rowlands.

David J Rowlands AC: Diolch, Llywydd. Deputy Minister, the proposal to make Newport the focus for economic growth has been welcomed by all in South Wales East, and we congratulate the Welsh Government on its announcement. However, I understand there has been criticism of this move by Cardiff city council, who argue that this would take jobs and investment out of Wales and undermine Cardiff's role as the economic driver of the Welsh economy.
Does the Minister not agree with me that their argument goes against the regional development plan and the setting up of strategic development plans that actually encompass the Cardiff capital region?

Lee Waters AC: Well, those are probably comments best directed to the leader of Cardiff council.The national development framework is out to consultation, and we look forward to considering all representations as part of that.

David J Rowlands AC: Well, I thank the Deputy Minister for that brief answer, but, Deputy Minister, the draft national framework encompasses local development plans, strategic development plans, developments of national significance, which all sit alongside 'Planning Policy Wales', and all supposedly based on a regional structure. Given this desire to move to regional centres of governance, could the Welsh Government give consideration to having just five regional centres of governance, perhaps based on the Welsh Assembly electoral regions, rather than the somewhat haphazard mix of local authorities-based economic regions that now exist or are proposed? These larger regions would have larger budgets, which would better facilitate strategic planning, particularly for infrastructure projects, thus underpinning the Government's strategic development plan for Wales.

Lee Waters AC: If I've understood the Member's point correctly, the regions that exist are based, certainly in the south-east, on the Cardiff capital region, which is a city region that's now been in development for some years and has the buy-in of the local authorities. You can certainly make arguments about where the line should be drawn between the mid Wales region and the Swansea bay city region, but you can always have these judgments about which bit should be in which and so on. We are willing to keep an open mind. If there's support within the local authorities for recalibrating those, we'd look at it, of course. But we have a small capacity at play here between the local authorities and the Welsh Government, and we need to pick an optimum number where we can get some gravity together to be able to marshal our resources properly to great effect, and the more we chop them around, the more difficult it becomes to get the results we're looking for.

Digital Connectivity Infrastructure

Dawn Bowden AC: 3. Will the Minister make a statement on digital connectivity infrastructure for the south Wales valleys? OAQ54618

Lee Waters AC: Yes. The south Wales Valleys have seen significant investment in digital connectivity infrastructure, with the Superfast Cymru scheme investing over £66.9 million to provide fast fibre broadband access to over 244,600 premises.

Dawn Bowden AC: Thank you for that answer, Deputy Minister. I know, of course, this is a largely non-devolved area of work, but I do recognise that, over the last few years, because of the failure of the UK Government to provide sufficient investment where the commercial market won't provide this vital service for our communities and business, the Welsh Government has stepped into this space and invested in high-quality broadband infrastructure, improving digital connectivity through the Superfast Cymru programme, as you've already highlighted—something I know that has a very positive impact in my constituency. So, can I ask the Deputy Minister: what work are you doing with Welsh Government colleagues to press the UK Government to follow your lead and to provide funding for high-quality digital infrastructure that can further support areas like Merthyr Tydfil and Rhymney to improve their productivity and their competitiveness as an area for investment?

Lee Waters AC: Thank you for that question. Dawn Bowden is absolutely right that this is a non-devolved area, but, because of market failure and the inactivity of the UK Government, the Welsh Government has been forced to step in here to divert significant resources from devolved services to address this clear failing by the UK Government to act. We have achieved significant results: a 95 per cent coverage of premises in Wales of superfast broadband. Now, we genuinely believe that fast internet access is now an essential modern service. The UK Government has a universal service obligation for postal services, so, if you post a letter to a farm track, isolated, it still—even though it may not be profitable, there's an obligation on the Royal Mail to deliver that letter. We think there should be a similar universal service obligation on telecommunications providers to provide modern, fast broadband.
The UK Government's come up with what it calls a universal service obligation, which is that in name only, I'm afraid. It's a right to request up to 10 Mbps, where the cost of building is no more than £3,400, from March 2020. So, this will still leave large parts of rural Wales without a functioning broadband service. So, that clearly isnot worth the paper it is written on. We are looking to see what we can do, and we have a statement and debate coming up shortly on what more the Welsh Government can do to reach the areas that we've yet to reach.
There is some progress in terms of other technologies, notably 4G and 5G, which are able also to deliver internet services. I met with the telecommunications companies recently, who I'm very pleased to say have come up with their own plan to achieve a step change in provision of 4G coverage in Wales by 2025, to increase coverage from 58 per cent to 86 per cent, without intervention by Ofcom. That, I must say, is very welcome, and we are working with them to see what we can do to help maximise that beyond 86 per cent if possible. We are worried that this will only be achieved by 2025, which still leaves a very long gap.
We are also working as part of bidding for 5G trials in rural areas. Simon Gibson is leading a task and finish group for the Welsh Government looking at 5G and, as part of that, has put in a bid to the DCMS 5G trials for test beds, and that is about to be considered by them, which would see a focus particularly on Blaenau Gwent, the Heads of the Valleys and Monmouthshire, which was the result of the £250,000 piece of work that the Government has supported. So, I think that there are things that we are doing, despite the fact that this is non-devolved. But, really, we need the UK Government to step up to the plate here PDQ.

Mohammad Asghar (Oscar) AC: Minister, last month, the Federation of Small Businesses produced a report on how broadband and mobile connectivity hinders small businesses in south-east Wales. With regard to Wales, they point out that mobile phones are increasingly becoming a key element of connectivity for small business owners. In areas where superfast broadband is not available, there are disproportionately high numbers of small firms that say that they use their mobile phones for internet banking and to interact with customers and suppliers at the same time. Minister, what action will you take to extend broadband coverage to areas that are currently hard to reach, such as parts of the south-east Wales Valleys? Thank you.

Lee Waters AC: Well, with respect to Mohammad Asghar, I have just answered that question. I would say to him that the UK Government—regardless of party, the UK Government has the lead role to play here. And, since his party has been in Government, we are falling woefully behind. We've stepped in where we shouldn't to provide this service. It is now time that the Government acts.

Economic Development in North Wales

Mark Isherwood AC: 4. How is the Welsh Government supporting economic development in North Wales? OAQ54626

Lee Waters AC: In the last year, the Development Bank of Wales has supported 109 businesses in north Wales, with a total of £40 million of investment in the region since 2016. Business Wales has helped more than 6,000 businesses and entrepreneurs generate £30 million of investment, £16 million in exports and nearly 3,000 new jobs.

Mark Isherwood AC: On 28 October, the Minister for Economy and Transport issued a written statement on the north Wales metro. Within that, much of the content was actually taken from the North Wales Economic Ambition Board's growth vision and growth bid documents—from integrated travel zones to the Wrexham to Bidston route to road and rail infrastructure. Heads of terms on the growth deal were due for agreement by the end of February, then deferred to July, then to October or November, and, once agreed, we understand that it will take four to six months to finalise the business case ahead of any spades in the ground.
However, yesterday, our local paper reported that representatives of the North Wales Economic Ambition Board joined the Welsh and UK Governments to sign the heads of terms and agree on the seven programmes that will form the deal from 2020 onwards, and the chair of the board said:
'Our next steps will be to begin implementing the priority projects and leverage funding from the private sector in key areas',
expected to reach a total investment of £1 billion. Why has the Welsh Government not shared this fantastic progress with us after all these months of delay, when it has been raised time and time again here? And how will the Welsh Government ensure that we will now be briefed on those priority programmes as they go forward, when they're likely to begin, and how they will be delivered?

Lee Waters AC: I'm not entirely sure what to make of that question, really. The delay in the signing of the North Wales Economic Ambition Board was a result of delays by the UK Government. He then seemed to criticise us for adopting policies that the north Wales ambition board had advocated in its plan. He normally criticises us for not collaborating sufficiently with the North Wales Economic Ambition Board, so I'm not entirely sure of the point he was trying to get at there.
We now have a way forward with the ambition board, and it's for them to work as a region. The whole point of these city regions is that leadership needs to come locally. It's for the local authorities working together to come up with a plan to satisfy the Welsh Government and the UK Government that they have robust plans in place that can be delivered on time and on budget, and then we will release the funds. It's not all the time to come complaining to the Welsh Government that they expect us to take the lead. This is the whole point of regional economic development: it's led by the region, and we work closely with them to do that. We co-produce that with them through our new regional economic approach, and the chief regional officer for north Wales is intimately involved with the board to do what we can. But this is a partnership and both partners have to act.

Trunk Road Preparedness

Russell George AC: 5. Will the Minister provide an update on trunk road preparedness in advance of potential adverse weather conditions? OAQ54613

Lee Waters AC: Yes. Winter preparedness is vital for our transport networks. We are in regular contact with local authorities to monitor salt stock levels, ensuring that we can maintain the safety and reliability of the network. We also work closely with rail and bus companies so that the public transport system is prepared.

Russell George AC: Thank you for your answer, Deputy Minister. Certainly in my constituency over recent weeks there's been a number of flooding issues where we've seen a number of road closures. And what constituents come to me about is the fact that they can't get information about where roads are closed, whether it be trunk roads or local-authority-responsibility roads. Now, I know the Minister has previously mentioned when he's come to the Economy, Infrastructure and Skills Committee that communication is something that he would like to see improved for planned roadworks. I appreciate that flooding is not planned, but it would be useful, would you not agree, to have a one-stop shop where Traffic Wales can list all road closures, whether they are planned or in the event of flooding incidents? And I would hope that you would agree it's not beyond the wit of man—

Joyce Watson AC: Or woman.

Russell George AC: —or woman, Joyce, to have the facility to allow local authorities to pass on information to Traffic Wales's website, so that we've got that one-stop shop for any kind of road disruption.

Lee Waters AC: Yes, I'd agree with that, and that is supposed to be happening. The Twitter feeds, certainly of the trunk road agencies that I follow, are regularly updating on both planned and unplanned road closures. So, if the Member has some particular examples of where that's failing to happen, I'd be happy to look into it further.

David Rees AC: Deputy Minister, as the winter comes, the hours of darkness get longer and, therefore, we need to be looking at driving in the hours of darkness, and we would, obviously, rely upon street lighting, where it is available, to be operationally effective, particularly along the trunk roads. Now, in Port Talbot the streetlighting and the overhead section has been taken away for several months. The stumps still stand there and in the darkness and the night you can't see the stumps because it's that dark. When will the Welsh Government actually be putting the lights back in place so that elevated section of the M4, which should be lit, is lit? It should be safer for drivers, particularly in an area that is criticised very much for the traffic congestion.

Lee Waters AC: Well, certainly, the columns were cut down in April after one of them collapsed. The other structures were found to have failures that made them a safety risk. They were, therefore, removed. A report was then commissioned to look at what options were available to us, and found that in the 20 years since the lights have been in place the standards have changed and, in fact, by modern standards, it wouldn't have been built like that in the first place, and the view of the experts was that the section of road was overlit. They're now looking at what the options are, of how alternatives can be put in place and how we can bear cognisance to the decarbonisation agenda. So, we would possibly have lighting options using less energy. So, that is currently taking place. It will take some three months for the lighting columns to be ordered, so it's unlikely to happen this financial year. We are considering options in the meantime, particularly floodlighting, but that would need generators. But we are hoping to have some recommendations we can act on in the coming months.

Transport Links in South Wales West

Caroline Jones AC: 6. What action is the Welsh Government taking to improve transport links in South Wales West? OAQ54625

Lee Waters AC: Thank you. The Welsh Government is working with local authorities to develop a comprehensive programme of enhancements across all modes to improve transport links across the region that will support our communities and deliver sustainable growth.

Caroline Jones AC: Thank you, Deputy Minister. While somewhat justifiably a lot of the attention has been given to congestion on the M4 around Newport and the impact that it is having on the economy of the entire M4 corridor, my region is also suffering from congestion on the motorway. Junction 48 has seen nearly a 50 per cent increase in traffic in recent years, and junction 47 sees nearly 80,000 vehicles per day. Unfortunately, for many, there is no reliable alternative. The main bus operator in Swansea has just been fined because its services are so poor and unreliable. Patients travelling to Singleton and Morriston hospitals found the bus late more often than not, and the service was often cancelled altogether. And as for the train, many of my constituents complain of overcrowding and delays, and the cost per mile is higher than their car. Minister, when can my constituents expect a cheaper, more reliable public transport service?

Lee Waters AC: Well, certainly in relation to junction 48 of the M4 at Hendy, I am able to announce that we will be making investments in the next few months. Improving the traffic flow and easing congestion there is part of the economic stimulus that we've announced in response to Brexit. We are making more than £3 million available to put in lights and active travel improvements at Hendy, which should make a difference this financial year, which I'm very pleased about.
In terms of the broader point, we are working with the Department for Transport on increasing rail capacity from Swansea to London. I must say, we've been very frustrated by the progress that's been made. This was announced, you will remember, when the electrification of the main line was cancelled, and in the two years since then we've had virtually no communication from the Department for Transport to help us progress this. They've not shared documents with us, and they've not progressed this in the way that they promised us they would when they cancelled the electrification of the main line.
I must say also that I'm disappointed that we couldn't act in this place on a more cross-party basis to take this forward. When Carl Sargeant was transport Minister and a coalition was put together to make the case for electrification on the main line, that was done on the basis of all parties in this Chamber working together and making representations to Westminster, and Carl led a very successful campaign. Since the Conservatives unilaterally cancelled that deal and have not delivered on what they said they would as a result of that, we've heard silence from the Conservative benches, who have not been working with us to lobby the Department for Transport to put that right.

Darren Millar AC: What about the M4?

Lee Waters AC: So, I would hope that—. We're talking about rail, Darren, and this is the deal that the UK Government, the promise your Government made—

Darren Millar AC: What about roads?

Lee Waters AC: Darren Millar is asking, 'What about roads?' Well, one subject at a time. Let's pay attention to rail, which is a deal that your Government made with all of us in this Chamber, not just our party, to deliver electrification of the main line, and you cancelled the deal.

Darren Millar AC: You promised improvements.

Lee Waters AC: You cancelled the deal, and you then said, in exchange for that—

Darren Millar AC: Since Transport for Wales took over the rail service, have you seen the state of it?

Lee Waters AC: If you pay attention, you'll understand my reasoning.

You don't need to listen to Darren Millar when he's sat down.

Lee Waters AC: Well, when his microphone is on, Presiding Officer, it's very difficult not to.

His microphone is not on.

Lee Waters AC: It's now gone off, I'm pleased to say.
You didn't stick to your deal. You haven't worked with us to get the replacement that you said you would put in place. So, it's time for you to examine your conscience and work with us on a cross-party basis again to deliver better improvements across the south Wales corridor.
Then, finally, to answer Caroline Jones's point, the south Wales Swansea bay metro, which we are working on along with the local authorities in the area, we have put some funding in that and we'll be putting more in to speed up the progress.
We also have increased capacity on the railway line. We've got new services and new fares being announced next month. We've got a 40 per cent increase in Sunday services across the network about to go live, as well as Sunday service on the Maesteg line for the first time. So, we are making progress, but we could make a damn sight more if the UK Government did its share of the work as well.

Transport Infrastructure in North Wales

Darren Millar AC: 7. Will the Minister make a statement on transport infrastructure in north Wales? OAQ54636

Lee Waters AC: Well, I'm looking forward to this. [Laughter.] The Welsh Government will invest in all modes to deliver the modern, high-quality transport system that's fundamental to achieving our sustainability, in all senses of the word.

Darren Millar AC: One area of investment that you are responsible for but haven't taken very seriously is the need for investment in the A55 trunk road in my constituency. You will be aware of the significant disruption that often takes place on the A55, particularly when there is road maintenance taking place or, indeed, when there are accidents on that road because of the lack of a hard shoulder along significant parts of it. The failure to address the congestion on the A55 is having a devastating impact on our visitor experience, it's causing ambulances not to be able to get to patients on time or to get them to hospitals when they need to, and, of course, it's causing untold damage to the economy in terms of people not being able to get to or from work or, indeed, places of education or employment.
I give you the example of the recent roadworks in Llanddulas, which caused tailbacks that amounted to over an hour of extra travel time through the A55 in my constituency, and caused untold havoc on roads, including the B5381, the B5383, which I'm sure you're very familiar with, and the A547, all of which are local roads that cost a significant amount to repair once the heavy traffic from the A55, for which they're not designed, has to travel along them in order to avoid the chaos that your Government causes because of the lack of investment. So, can you tell us when will we see a proper upgrade of the A55 throughout north Wales, not just in Labour-held constituencies?

Lee Waters AC: So, just let me get this straight, is he complaining that we're not investing, or is he complaining that we are investing and then complaining about the roadworks that that investment causes? I'm not entirely clear of the tenor of his complaint. He can't have it all ways. When we are upgrading and investing, it involves disruption, and that is unfortunately a fact that we can't get away from.
We are investing in a range of initiatives at junctions 15 and 16 of the A55, where we have junction improvements and developments, and the A55 Abergwyngregyn to Tai'r Meibion improvement scheme, which is currently seeing investment. [Interruption.] It's a corridor, Darren Millar; you need investments right along the corridor. In the Flintshire corridor, the Dee river bridge improvement and in the Menai crossing, we are investing. In fact, we're investing £60 million a year of capital funding for local authorities to invest in a highways refurbishment scheme.
But tackling congestion isn't just about road improvements, it's about a multimodal approach to give people alternatives to roads, and we are investing significantly in the railway. And I'm sure he will join me in welcoming an announcement that I can make—[Interruption.] Absolutely, there is something for Clwyd West. Pay attention. I look forward to the press release from you welcoming the fact that I can today announce a £1.6 million investment in Old Colwyn promenade for the upgrade to improve active travel facilities and raised coastal defences. [Interruption.] He says, 'About time'; there's no pleasing some people, is there? So, we are investing in Clwyd West and we're investing in active travel to encourage modal shift, so I'm sure you'll welcome that.

Increasing Passenger Capacity in Islwyn

Rhianon Passmore AC: 8. Will the Minister provide an update on Transport for Wales's plans to increase passenger capacity for rail users in Islwyn? OAQ54629

Lee Waters AC: The Minister, Ken Skates, set out his vision for rail in Wales in his statement on 24 September. As part of our ambitious plans for the south Wales metro, Transport for Wales will deliver additional services, with improved rolling stock and stations in Islwyn.

Rhianon Passmore AC: Diolch, Deputy Minister. Thank you for that answer. The Ebbw Vale to Cardiff line reopened by the Welsh Labour Government has been one of the most visible success stories of devolution. In the 11 years since the line has been reopened, passengers have flocked to use the hourly service. As the Member for Islwyn, I will continue to eulogise around the previously unavailable benefits that this has offered the Islwyn communities of Risca, Newbridge and Crosskeys. However, forward movement is the point, as will be the extension to Newport.
Transport for Wales announced in October of this year plans to introduce far greater capacity for up to 6,500 more commuters a week from December this year across the network, and the additional news that Islwyn passengers on the Ebbw Vale to Cardiff line will have the benefit of fit-for-purpose modern class 170 trains with real space on board, passenger information systems, accessible toilets, air conditioning, Wi-Fi and power sockets. So, Deputy Minister, what can I tell the people of Islwyn about when they will see this improved capacity for carriage trains on their line, and what is the timescale for the first class 170 train to run on that line?

Lee Waters AC: Well, I think Rhianon Passmore has stolen my thunder. [Laughter.] She's included the announcement in the question,and she's quite right to say it. We should be proud of the real improvements we're making to the communities she represents so ably in the Chamber. From 16 December this year, as part of the December timetable change, there will be class 170 trains between Cardiff and Ebbw Vale and between Cheltenham and Maesteg, with the benefit of modern class 170 trains, with more space, onboard passenger information systems, accessible toilets, air conditioning, Wi-Fi and power sockets, which will provide space for up to 6,500 more commuters every week, a real tangible benefit, as a result of the rail leadership the Welsh Government are providing. And by December 2022, there'll be even more increases in capacity, with an extra 180 seats on the Ebbw Vale to Cardiff line in morning peak, and that is something we should celebrate, and it is as a direct result of the action this Labour Government is taking to improve the facilities for people in Islwyn.

The Economy of the Swansea Bay Area

Mike Hedges AC: 9. Will the Minister make a statement on the economy of the Swansea bay area? OAQ54620

Lee Waters AC: Yes. Between 2011 and 2017, gross value added per head in the Swansea bay area increased by 14.3 per cent, and in 2018, there were 18,025 active enterprises in the Swansea bay area.

Mike Hedges AC: One of the highlights of it is the SA1 development that is in my constituency, which is a mixed development including houses and flats, hotels, restaurants and major employers that includes Admiral, University of Wales Trinity Saint David and companies with substantial growth potential, such as the Wales Centre for Advanced Batch Manufacture. Much of that has been done due to investment by the private sector and the Welsh Government. How much has been invested in the area, and how much more is there expected to be?

Lee Waters AC: The Welsh Government has invested £59 million in the SA1 development, and on top of that, Swansea University has secured £100 million of European Union funds to support major new facilities and research and development programmes in the development. On top of that, working with the Swansea bay city region and the UK Government, we are investing further in Swansea city centre through the city deal. We would like to make further interventions through the movement of the Driver and Vehicle Licensing Agency into Swansea city centre, which we think would have a tangible impact on the whole of Swansea—Swansea East and West. Unfortunately, we've had no luck engaging the UK Government on that, but I would certainly welcome a campaign of regional Members to try and work with us to try and get that, because I think that could make a significant impact on the fabric of Swansea.
I think the other question, to respond to the broader point that Mike Hedges is making, is how we spread the development of SA1 beyond that into his constituency, which has some of the most economically challenged wards in the country. There, our regional approach and our commitment to the foundational economy I think has much potential.

Finally, Suzy Davies.

Suzy Davies AC: No. 9, yes?

Yes, no. 9.

Suzy Davies AC: Okay. Thank you very much for that. Sorry.

Suzy Davies AC: You mentioned the Swansea bay city deal, Deputy Minister, and, of course, we're waiting for the first £18 million of that to come through. I understand the delay is down to Welsh Government not telling the city deal lead, Rob Stewart, a Labour colleague of yours, the terms and conditions of the £18 million that they've been waiting for. He's complained that it's taken 16 weeks, which is far too long. Can you tell us what the reason for the delay is, please?

Lee Waters AC: The way that the city deal project has been set up by the UK Government and the Treasury has been extremely challenging and complicated for local authorities that are not kitted out to take projects through a five-case business model approach. Two independent reports done into the city deal pointed out that the capacity did not exist locally and, as a result, great frustration was building up on the part of local authorities who had the ideas and they had the plans to take these projects forward, but simply could not meet the tests of the business cases demanded by the Treasury, which we then had to discharge as part of the heads of terms of the city deal. So, it's been a very frustrating process all round. Those independent reports suggested a series of reforms to blast that out of the way, and the region is making progress in delivering those. Part of meeting the concerns laid out in that report was the implementation of terms and conditions to make sure the money would be well spent, and we've been working through with the region the detailed implementation of those terms and conditions. I believe we are very close to the point of being able to sign them off.

Thank you to the Deputy Minister.

2. Questions to the Counsel General and Brexit Minister (in respect of his Brexit Minister responsibilities)

The next item, therefore, is questions to the Counsel General in respect of his Brexit Minister responsibilities. The first question [OAQ54630] has been withdrawn, therefore question 2—Mike Hedges.

The Impact of Brexit on Drinking Water Purification

Mike Hedges AC: 2. What assessment has the Counsel General made of the impact of Brexit on drinking water purification? OAQ54619

Jeremy Miles AC: Primary responsibility for providing clean, safe drinking water lies with the water companies. The water companies, working with the Department for Environment, Food and Rural Affairs, water regulators and the devolved Governments, carried out robust and detailed mitigation planning to prevent impacts on the supply of safe and clean water once the UK leaves the European Union.

Mike Hedges AC: One of the most important things in life is clean drinking water, as many people in some third-world countries discover daily, unfortunately. What Brexit has taught us, however, is how hollowed-out our economy has become and how dependent on imports for basic necessities we as a country have become. While it's not life changing to only be able to buy seasonal vegetables, lack of clean water is life changing and possibly life ending. What is the Welsh Government doing to ensure the continuity of supply of chemicals needed for water purification, and what support are they giving to the water company covering most of Wales and the other water company covering the rest of Wales in order to ensure that the water we get out of our taps is clean and of the standard we expect and we are having now?

The Deputy Presiding Officer (Ann Jones) took the Chair.

Jeremy Miles AC: I thank the Member for that supplementary question. This is a very important question, of course. Wales has some of the highest quality drinking water in Europe, with our compliance against the relevant standards standing at 99.95 per cent. So, it's an important issue for us and we will always want to continue to align to those standards, wherever Brexit takes us. He will be aware, of course, that security of the water supply in the UK has been part of the Operation Yellowhammer planning process, and the water industries' representative body, Water UK, and the water companies, including those operating in Wales, have been working collectively to ensure they have a granular understanding of the supply chain. They've taken specific measures in relation to stockpiling critical chemicals used to treat water, as well as establishing mutual aid arrangements with other water companies. In a worst-case scenario—but we think it's very unlikely this would be necessary—the statutes give Welsh Ministers power to issue directions to our water companies to mitigate any effects that might arise.

Industry in North Wales

Jack Sargeant AC: 3. What discussions has the Counsel General had with industry in north Wales following the announcement of a Brexit extension until 31 January 2020? OAQ54631

Jeremy Miles AC: My ministerial colleagues and I have engaged widely with businesses on Brexit issues as part of our engagement with stakeholders across Wales. Most recently, the Minister for Economy and Transport led a round-table meeting on small and medium-sized enterprise access to finance on 24 October in Wrexham.

Jack Sargeant AC: Diolch yn fawr, Minister, for that answer. Alyn and Deeside is home to some of Wales's most high-tech and advanced industry and the dedicated and skilled workforce that are within that area. For these employers and those employees, planning is key. Can the Minister detail further the contact he and his officials, and any other ministerial colleagues, have had with the major employers within the area and the associated trade unions, like Unite the Union, to ensure that they can continue to plan? Can he also spell out what other support is there available to them? And, finally, how confident is he that the UK Government, the Tory UK Government, are listening to these groups and these employers for the sake of their families and are sharing the relevant information with them?

Jeremy Miles AC: I thank the Member for that question. Since his time in the Chamber, he has always sought to understand the impact of Brexit on his constituency and on employers there, so I appreciate his continuing concern in relation to that.
The Welsh Government continues to engage with businesses in a variety of different ways, either face-to-face direct engagement, round-table sessions, which both the Minister for the Economy and Transport and I and others have led on, communications via Business Wales and the business support networks, as well as a range of media channels. He'll know that the Government is providing ongoing business support through the economy futures fund and the work of the Development Bank of Wales, and the Minister for Economy and Transport most recently announced a further £6 million for the Brexit resilience fund, announced at the end of last week, which consists of a blend of grant and loan funding that companies can apply for. And in addition to that, we continue to do everything we can to publicise and promote the information that we have on the Paratoi Cymru/Preparing Wales website, which includes the Brexit portal, which has had, I think, 39,000 users to date.

Mark Isherwood AC: In September, the CBI director general Carolyn Fairbairn said:
'So many businesses here in Wales are full of optimism and enthusiasm. They want to be talking about—and acting on—Welsh strengths. To signal that Wales is open for business. But desperately want to put an end to uncertainty.'
Quoting businesses in north Wales at the start of October, the Daily Post said:
'Uncertainty fuels uncertainty. We need an end to all Brexit uncertainty.'
In mid October, the chair of Ocado and the former Marks and Spencer boss, Stuart Rose, said he now supports the new UK Government deal, saying he was involved in the original 'remain' campaign, but he's also a realist, and he said he hoped he's a pragmatist and a respecter of the democratic process.
And, finally, the chief economist and strategist at city investment firm Schroders said passing the new deal could unlock stronger growth in the economy:
'if the deal passes through Parliament on Saturday',
which it didn't,
'we should see stronger growth in the UK economy as the cloud of Brexit uncertainty lifts.'
What action are you taking to listen to industry and business, whose key concern is that lack of certainty, and to avoid, therefore, dragging this out for months more as parties seek to renegotiate, re-referendum or what have you. The future growth of the Welsh economy and the well-being of employment and people in Wales depends on that certainty, articulated so effectively by business. Uncertainty needs to end.

Jeremy Miles AC: Well, I welcome and appreciate the Member's concern for the interests of business. If only that was shared by his parliamentary party in Westminster who have ridden roughshod over the concerns of business since the beginning of the Brexit debate.
I, too, heard the remarks of Carolyn Fairbairn, and I think I also heard her say that business investment was 26 per cent under trend as a consequence of Brexit. And also, business growth was several percentage points beneath what would we expect it to be.
He's right, in fact, to identify the question of uncertainty. We hear every day in Wales the impact that Brexit is already having on businesses and employers and livelihoods right across the country. But the alternative universe that he's positing is one where this deal is good for business, and it just is not. And the notion that this deal draws this matter to a certain close is complete fiction. This is a bad deal and it gives us the certainty of a bad deal for businesses right across Wales. We are looking at substantial additional costs for small businesses that export that they can barely afford to pay. Maybe he'll confirm to me if the UK Government is planning on compensating them for that. But otherwise, these are significant burdens that businesses in Wales can ill afford to have to take on.

Rhun ap Iorwerth AC: Uncertainty needs to end, yes, but for very many businesses, the very threat of Brexit needs to end. Let me read to you from an e-mail I've received from a constituent who runs a small consultancy from Anglesey, with the majority of the business's money coming from the European Union:
'The damage that Brexit so far has done to our business is significant',
he says,
'mainly due to the ill feeling that other countries feel towards the UK. We have been excluded from several projects because of risk or other such excuses. This is a real pity for what was a growing business providing income, tax and jobs in the area. Now we're stagnant and waiting for all this to pass so that we can resume growth.'
And he was asking for my reassurance that I'd campaign for 'remain'. I can certainly give him a categorical assurance on that front. But what countless companies like that can see is that the delays of a few months here or there aren't really what's relevant—it's that threat of what they lose from not being within the European Union, and there is no deal, they see, that is as good as the one that they have now.

Jeremy Miles AC: I will, if I may, echo the points the Member has just made. I mean, his experience and the issues that his constituents have raised with him strike a very clear chord with what we hear from businesses all the time. It was only last week, I think, or the week before, that I had an e-mail from a leading figure of the business community saying the notion that the Boris Johnson deal is the solution to business uncertainty is complete fiction. And I think, and I share with the Member his conviction, that the best way of getting the certainty that businesses in Wales have been able to flourish under, as a consequence of our membership of the European Union, is for us to have a referendum where we can campaign to remain and win that argument.

Questions Without Notice from Party Spokespeople

We now turn to spokespeople's questions, and first this afternoon is the Conservative spokesperson, Darren Millar.

Darren Millar AC: Minister, will you outline the Welsh Government's position on Brexit?

Jeremy Miles AC: The Welsh Government's position on Brexit is that any version of Brexit is a worse deal for Wales than remaining part of the European Union and that the only way that people in the UK can get their voice heard in this debate is to vote Labour at the next election and have a referendum, where we in Wales will campaign to remain.

Darren Millar AC: I'm pleased to hear at least a consistent message coming from your mouth this time, because, of course, we've had all sorts of flip-flopping from the Welsh Government in recent months. Now, you've attempted there to articulate the UK Labour Party's position on Brexit, but the reality is that the UK Labour Party doesn't have a position on Brexit. What you've got is a position on holding a second referendum, because your leadership, the leadership of the UK Labour Party, doesn't have the bottle to actually say which way it will campaign in that referendum. Now, my party is very clear. We've got a policy to get Brexit done. Other parties, to be fair to them, are also very clear that they want to remain. But the UK Labour Party is doing the hokey cokey on this matter, with one foot in and one foot out on whether to leave or remain.
Now, Minister, I'm sure that you would agree with me that it's vital that the public know what the position of any future UK Government is on Brexit. So, do you agree with me that it's time for your colleagues in the UK Labour Party to come clean with the public, to set out a clear position on Brexit, and to give voters across Wales the opportunity to have their say on 12 December, knowing exactly what you stand for?

Jeremy Miles AC: I think this exchange is rather poignant really, and I think his interest in the politics of Westminster is particularly poignant. He mentions flip-flops—I should commiserate with him; he obviously knows first-hand the impact of the flip-flopping of his constituency colleague David Jones, and so I just commiserate with him about that. I'm sure that he has flip-flops and broken promises very much uppermost in his mind in these questions.

Darren Millar AC: I'm sorry, I didn't actually hear you set out the position of your party. But, look, here's the situation: the idea of a second referendum that your party is positing is absolutely absurd. Why would anybody expect the Labour Party to respect the result or outcome of a second referendum if you haven't respected the first? The truth is, and it's an inconvenient truth for you, I know, but Wales voted to leave the EU in the referendum on Brexit, including 57 per cent of your own constituents. Yet, in spite of this, you and many others in this Chamber have done everything you can to block the instruction that we have received from the people of Wales and the rest of the United Kingdom. So, you've got no respect for democracy, you've got no respect for those who voted to leave, and absolutely no intention of delivering what the people of Wales voted for.
So, I ask you this: how can anybody trust the Labour Party to deliver on the result of a second referendum if they haven't been bothered to support the outcome of the first?

Jeremy Miles AC: And this from a party that campaigned in Westminster against the Assembly after the result of the referendum. I think it's quite extraordinary your position on this argument, Darren. Let me put it very simply for you—[Interruption.] I'm happy to answer the question; perhaps you can let me to do that. The policy of the Labour Party is one of respect to the electors of the United Kingdom, to whom promises were made, and promises have been broken, and they were largely broken by people who are running the Government of his party in Westminster. It is absolutely clear to us the only way of drawing a line under this—these three years of broken promises on the part of his party—is to give the British people an opportunity to have their say, and to have their say on the deal that Boris Johnson has brought back, which we are confident will be exposed as being a much worse outcome than remaining a member of the European Union.

The Plaid Cymru spokesperson, Delyth Jewell.

Delyth Jewell AC: Thank you. Minister, I would like to ask you about the Labour Party’s plans for negotiating a new Brexit deal. Now, I’m aware that you’ve been in Brussels recently meeting with representatives of the European Union. Can you tell me whether you had any discussions with them about your party’s plan to negotiate a new deal based on creating a new customs union? And did you ask them whether they would be willing to allow another extension to article 50 in order to provide time to negotiate this deal and to then call a referendum?

Jeremy Miles AC: Thank you for the question. The question of the Welsh Government’s position on Brexit was at the top of the agenda and we made it clear that our Government here was in favour of remaining a member of the European Union. Of course, the people we were meeting were expecting me to say that. We didn’t discuss, of course, in detail the question of what sort of agreement we would negotiate. But, on other visits and other occasions in the past, we have presented to them the ‘Securing Wales’ Future’ document, which was agreed jointly with Plaid Cymru, and so they have a clear picture of the kind of Brexit that, if we had to leave, we think would cause the least damage here in Wales.

Delyth Jewell AC: Thank you. I would like to ask as a result of that whether the Welsh Government will carry out an economic impact assessment of a new deal negotiated by Jeremy Corbyn on the economy and ports of Wales. Of course, there’s not much detail about the nature of this available at the moment, but I assume that, as a Labour Minister in a Labour Government, you know your party’s intentions in terms of the deal that you want to negotiate. You will be aware that Michael Gove told me that the current UK Government hasn’t conducted an impact assessment for Welsh ports, which is hugely concerning given the importance of the port of Holyhead particularly. Can you confirm, therefore, that it’s your Government’s intention to conduct detailed impact assessments of the Jeremy Corbyn deal on the Welsh economy and Welsh ports before any referendum, if your party is in government after the election?

Jeremy Miles AC: I’m not talking on behalf of Jeremy Corbyn, or any other member of the benches in Westminster, but I can speak on behalf of the Welsh Government on this question. The process that we have been involved in from the very beginning has been one based on evidence and facts and information from the real world, rather than slogans and hopes. And I’m pleased that we’ve managed to publish, with Plaid Cymru, a document that includes that evidence. The Member will know that, since then, we have published a number of other papers that show all sorts of impacts—economic and otherwise—of the Welsh Government's policy position on Brexit.

Delyth Jewell AC: Finally, Minister, I want to turn to the news that Alun Cairns has finally resigned as Secretary of State for Wales, following revelations he helped to cover up for an ally who deliberately sabotaged a rape trial. I'm sure you'll agree with me that Alun Cairns's actions were disgraceful, indefensible and indicative of a deep rot at the heart of the Conservative Party in Wales. It's quite apparent that Alun Cairns, and other senior members of the Conservative Party in Wales, were aware of what Ross England had done before they selected and endorsed him as their candidate. And I'd be interested to know whether you agree with me that an inquiry needs to take place to ascertain who knew what and when—

These are questions to the Counsel General about Brexit.

Delyth Jewell AC: —and that everyone in a position of power implicated in that scandal should resign. In terms—

Sorry. No, your mikeis off. Sorry, Delyth, your mike is off. These are questions about Brexit; it is not about anything that may have been said over the Twitter for that. It's about Brexit. You started off okay, but I think you've strayed off, so if you can relate it to a Brexit question, that would be fine.

Delyth Jewell AC: Okay. In terms of your duties as Brexit Minister, I'd like to ask you how Alun Cairns's resignation will affect your Government's workings with the UK Government? Do you expect them to appoint a replacement as Secretary of State for Wales ahead of the election, in terms of the duties that he had on the JMC(EN)? And does this leave inter-governmental workings, in terms of Brexit preparations, at any kind of impasse?

Jeremy Miles AC: In the context of Brexit questions, I won't be drawn on the broader point, but I think the First Minister has made our position clear in relation to matters surrounding the former Secretary of State for Wales. In relation to questions of relevance to Brexit, in my experience, the place where we have made most progress in discussions with the UK Government is where we have been able to deal with them directly. Even then, it has been a significant challenge in many, many ways. But it is evidently the case that those direct contacts are the best way of protecting Wales's interests into the future.

The Impact of Further Brexit Delay

Angela Burns AC: 4. Will the Counsel General make a statement on the impact that a further delay to a Brexit deal being passed will have on Carmarthen West and South Pembrokeshire? OAQ54642

Jeremy Miles AC: The flextension to 31 January means a disastrous 'no deal' Brexit has been avoided or at least postponed. Economically, it means the maintenance of the status quo. It also provides the opportunity to reject Boris Johnson’s hard Brexit deal and put the decision back to the people.

Angela Burns AC: I had a feeling you'd probably say something along those lines, Counsel General, so I'm glad I'm not disappointed. Of course, I think, ultimately we all hear what we want to hear, and I'd like to tell you what farmers in my constituency are saying to me, because they need and want certainty surrounding Brexit, and I know from the many conversations that I've had, they want a deal done. One way or another, they want a deal done so they have certainty, so that they can plan for the future. Yet, last month, in Westminster, the Labour Party voted against approving the Conservative Government's new deal, which they had struck with agreement with the EU, which seemed to be supported by quite a wide variety of different organisations, different sectors of industry, farmers, and so on. And the policy of the Welsh Government seems to be to have a second referendum. What guarantee can you give my farmers in Carmarthen West and South Pembrokeshire that if you did go and have that second referendum, you would actually bother to implement the result?

Jeremy Miles AC: I thank the Member for acknowledging the consistency of my approach at the start of her question. I have farmers discussing their concerns with me as well, and the concerns they ask me are about what certainty do they have of replacement funding from the UK Government for the support they get at the moment. What funding can we secure for regional investment in Wales from the UK Government to replace the support we are able to provide them at the moment? Unfortunately, the position, I have to say to them, is that, despite the sunny slogans of Boris Johnson, in terms of the hard reality, I cannot give them the assurance that they want. The reason for that is that the UK Government has been completely neglectful of the agricultural sector as a significant part of our economy, despite the headline-grabbing statements that we sometimes see. So, that is the reality and that is what farmers are saying to me, and I'm surprised that farmers in her constituency aren't also saying to her that they are concerned the UK Government isn't living up to its responsibilities.

David Rees AC: Minister, the constituents of Angela Burns clearly highlighted the concerns over a possible delay, but what are your considerations for those same constituents if this deal goes through and we have 11 months to negotiate a free trade agreement, which is unlikely? Everybody other than Michael Gove seems to think that's impossible, and he's adamant that they will not seek an extension to any transition period, which means there'll be a 'no deal'exit on 31 December next year. What are the implications for those constituents if that happens?

Jeremy Miles AC: Well, I think the Member makes a very important point there. Although 31 January gives some confidence in relation to an imminent 'no deal', the point he makes is at the heart of the weakness in the deal that Boris Johnson has brought back from the European Union, which is that there is no certainty that we are not simply looking at a deferred 'no deal'exit. And we know what damage that will cause to the farming sector, to various sectors of our economy and our communities at large. I share with him his scepticism that the kind of free trade agreement—unless it's extremely minimalist—that he describes in the political declaration can be achieved within that period, even on his own terms. Again, if we just look at the UK Government'sown figures here, even if those trade agreements are possible to put in place, the advantage that brings to the UK economy is absolutely dwarfed by the damage that that sort of relationship with the European Union would pose to our economy into the future.

The Erasmus+ Programme

Vikki Howells AC: 5. What discussions has the Counsel General had with the Minister for Education about the continuing participation of students from Wales in the Erasmus+ programme following Brexit? OAQ54639

Jeremy Miles AC: In addition to regular discussions on this and related issues at Cabinet sub-committee, I've met with the Minister for Education separately on a number of occasions to discuss the potential impacts of Brexit on the Erasmus+ programme.

Vikki Howells AC: Thank you, Counsel General. As you will know, Welsh learners have really benefited from Erasmus+, with over €40 billion being brought into Wales between 2014 and 2018 to support over 7,000 participants in 245 projects. I know the EU Commission has suggested that, for the cycle starting in 2021, the scheme will become global in scope, but, as with so much else, the uncertainty caused by Brexit means that there are question marks around future Welsh and UK participation. What discussions have you had around the continued participation of Welsh learners, for whom the experience can be life changing, and, in particular, around enabling vocational learners to access these opportunities?

Jeremy Miles AC: This is a really important point, so I thank you for raising this. It was on 16 October that I met—courtesy of Colegau Cymru, who I thank for arranging this—a group of vocational learners from across south Wales who had benefitted from participating in Erasmus+ placements, and I heard at first hand about the benefits of that programme, which they described in their own lives and in their own workplaces. It was about building confidence, about personal development, about learning different perspectives on the world and the world of work, building relationships with people in other countries, and also taking back to their own workplaces new ideas and fresh ways of looking at things. All of them were clear that this was not the sort of thing that they would otherwise have been able to take advantage of in their own lives.
She talks about the future scoping of the replacement Erasmus scheme, and it strikes exactly the kind of priorities that we would wish to see: supporting disadvantaged learners into Erasmus, part-time learners, and a more global scope in many other ways. Those are exactly the kinds of things that I'm sure we would all want to see our young people in Wales being able to participate in fully.
I know that the Minister for Education has been advocating for this position with the UK Government from the outset, and I believe that, more recently, we've had some confidence, if we can't participate in the Erasmus replacement scheme into the future, which remains our priority, that the UK Government has a UK-wide scheme in mind. But the fundamental point, coming back to the point that I made earlier, is that the Treasury has to commit funding in order for that to happen, and, without that funding, it will not be able to be a reality.

Cross-border Crime

Joyce Watson AC: 6. What discussions has the Counsel General had with counterparts in the UK Government regarding tracking cross-border crime following Brexit? OAQ54637

Jeremy Miles AC: I myself last discussed matters relating to the future security partnership at the February meeting of the ministerial forum. Nowhere else in the world has the level of close multilateral co-operation in relation to law enforcement and judicial matters that exists between EU member states, and that co-operation must continue even if the UK leaves the European Union.

Joyce Watson AC: Thank you, Counsel General, for that answer. Following the horrendous deaths of 39 Vietnamese migrants in Essex last month, a number of senior MPs and experts have cautioned that the UK faces a real risk of being excluded from Europol and its agencies, including the anti-trafficking unit and the European Migrant Smuggling Centre, post Brexit. They went on to say that, even with a deal, the UK would have downgraded access to those organisations.
The UK's right to access and share information on a whole host of security issues like human trafficking and international crime could be severely hampered at a time when international co-operation is needed the most. Being excluded from an organisation that has an unrivalled ability to track crimes across Europe and beyond is of grave concern. So, Minister, what discussions have you had with the Westminster Government—or will you have when it returns—about how they intend to maintain access to all those agencies that I've just mentioned, especially now, when we're in such turbulent times internationally?

Jeremy Miles AC: Well, I'll reassure the Member that it's exactly that kind of close engagement and involvement into the future with the various Europe-wide law enforcement bodies and agencies—. It's exactly that kind of relationship that I was advocating in that ministerial forum and I and other Ministers have continued to press for in the interim period. As she says, whether it is Europol or Schengen, the SIS II system, whether it is about sharing passenger name records or criminal records, there is a multiplicity of EU-wide law enforcement and security arrangements from which we benefit at the moment, and from which exclusion will have a real impact on us and on our security.
Now, of course, the ambition that the UK Government has is to negotiate the best available relationships with those organisations after Brexit. But the reality is that there are several obstacles in the path of those negotiations delivering the same level of engagement and involvement that we currently have,not least amongst them the question of the UK's data adequacy. All of this is shared data, and, as we know in this Chamber, if we become a third country, we'll have to restart a process of qualifying to access data of any sort. It's a major stumbling block. As a non-Schengenthird country our access to a number of these arrangements will, even at best, be depleted.
And there's a third dimension here as well, which is that many of them require a level playing field in terms of human rights protection, and losing the benefit and the shelter of the EU charter and fundamental rights may itself pose an obstacle to getting the kind of arrangements we would want to see in place in those negotiations.

Safeguarding the Welsh Economy

John Griffiths AC: 7. What measures is the Counsel General taking ahead of Brexit to safeguard the Welsh economy? OAQ54635

Jeremy Miles AC: Whilst we believe the best way to safeguard the Welsh economy is to remain in the European Union, the Welsh Government is doing everything in our power to safeguard the Welsh economy. This includes using measures such as our Brexit resilience fund, where we announced an additional £6 million funding for this week.

John Griffiths AC: Counsel General, a lot of the economic activity in Wales consists of the work of small and medium-sized enterprises, and I believe they're crucial to our economy. They face a lot of cash-flow and confidence pressures in the light of Brexit and what Brexit may bring. I believe a crucial support for them is the Development Bank of Wales, so, could you offer some reassurance today that that development bank is best placed to offer that support, crucial support, to our SMEs before and post Brexit?

Jeremy Miles AC: Yes. I thank the Member for that supplementary. The role that the Development Bank of Wales can play, in particular in engaging with the small and medium-sized business community, is going to be absolutely essential in a post-Brexit world, if that is what comes to pass. Obviously, the Minister for Economy and Transport has significant dealings with the bank. I myself have met with the chair and the chief executive to discuss their arrangements around preparedness and the redeployment of staff if we were to come to that situation.
He says that cash flow and confidence are likely to be two issues that hamper businesses generally, and I agree with that. The Minister for Economy and Transport announced £100 million of capital for the Wales flexible investment fund, which is managed by the Development Bank of Wales, and earlier this year announced more than £120 million further funding for various funds that are manged by the development bank, and the whole point of those is to make funding available in a way that is flexible and appropriate for the particular needs that businesses may have in a post-Brexit world.
We've been clear as a Welsh Government, and we've been clear in pressing the UK Government of this view, that, if we come to that situation, it's incumbent on us to do all that we can to support businesses that can be viable into the medium term, if you like, to get over what will be, inevitably, a very turbulent time. We have not persuaded the UK Government of that view, but that remains very firmly our view.
Of course, we hope for a situation where we have a referendum and a campaign to remain that succeeds, where this risk to those businesses is eliminated. But we have to prepare for a situation in which that doesn't come to pass.

And, finally, question 8—Lynne Neagle.

Workers’ Rights

Lynne Neagle AC: 8. What assessment has the Counsel General made of the impact of the latest withdrawal agreement on workers' rights in Wales? OAQ54615

Jeremy Miles AC: Well, the withdrawal agreement fails to provide any guarantees that the UK Government is committed to retaining alignment with existing EU rights and protections for workers in Wales.

Lynne Neagle AC: Thank you for that very clear answer, Minister. It is absolutely clear that the latest withdrawal agreement represents a further weakening of the UK Government's commitment to workers' rights. Frances O'Grady, secretary of the Trades Union Congress, has said:
'This deal would be a disaster for working people. It would hammer the economy, cost jobs and sell workers’ rights down the river.'
Do you agree with Sir Keir Starmer, the UK shadow Brexit Secretary, that there would be a real danger if this deal goes through that there would be a serious weakening of workers' rights and that it would be very likely that the UK would follow other models, such as the United States', which have considerably weaker protections for workers than we currently enjoy here in this country?

Jeremy Miles AC: Well, I think the Member hits the nail on the head. That is exactly, I think, the risk that comes out of this agreement. In fact, I'd go further than to say that it's a risk; I think the nature of the agreement discloses the kind of destination in which the current UK Government wants to take the UK. It's one of deregulation, where the UK has given up on workplace protection and social and environmental rights of the kind that we in Wales both take for granted and would wish of course to continue to align with.
As her question implies, this deal is even worse than Theresa May's deal, which at least committed the Government to maintaining the current level of EU workers' rights and gave Parliament some mechanism into the future around that. The kind of vision that is outlined in this agreement is fundamentally at odds with the priorities of the Welsh Government here in Wales, as set out in the work of the Fair Work Commission recently, which ensures that we as a Government will continue to take every step that we can to make sure that workers in Wales are not disadvantaged if and when we leave the European Union.

Thank you very much, Minister.

3. Debate under Standing Order 25.15 on The Government of Wales Act 2006 (Amendment) Order 2019—Section 109 Order relating to Electoral Registration Officers

Item 3 on the agenda this afternoon is a debate under Standing Order 25.15 on the Government of Wales Act 2006 (Amendment) Order 2019—section 109 Order relating to the electoral registration officers. I call on the Counsel General and the Brexit Minister to move the motion—Jeremy Miles.

Motion NDM7176 Jeremy Miles
To propose that the National Assembly for Wales, in accordance with Standing Order 25.15 approves the draft version of The Government of Wales Act 2006 (Amendment) Order 2019.

Motion moved.

Jeremy Miles AC: Diolch, Dirprwy Lywydd. I move the motion to approve this Order in Council under section 109 of the Government of Wales Act 2006. This Order makes some progress in addressing issues of competence that have arisen as a result of the Wales Act 2017. When the Order is made, it will ensure that the Assembly can effectively and comprehensively legislate in relation to electoral law relating to devolved Welsh elections. This was of course the original intention of Parliament when the Wales Act 2017 was developed.
It's also necessary to allow for coherent regulations to be made in relation to canvass reform in time for the 2020 annual canvass, and to ensure that the lines of executive competence between the UK Government and Welsh Ministers are clear. Electoral law is contained in a wide array of primary and secondary legislation, and the role of electoral registration officers is essential to electoral registration and thus to electoral reform. Without the ability to confer functions on an electoral registration officer in new legislation, the electoral functions of the Welsh Ministers are significantly restricted.
It became apparent through the canvass reform project that the particular mechanism by which electoral functions, and specifically those that affect electoral registration officers, have been transferred means that no one person, the Welsh Ministers nor the Secretary of State, would have a fully coherent set of powers in relation to devolved elections. Once this Order is made, we will be able to progress the canvass reform agenda, which will streamline the registration process in Wales and will make it easier for the electorate to engage with.
The Order will also enable us to make the necessary changes to the role of electoral registration officer in relation to devolved elections in primary legislation without needing to seek the consent of the UK Government each time. This includes changes we will be proposing in our forthcoming local government and elections (Wales) Bill. This will support the electoral reform agenda in Wales and it will enable the modernisation of electoral practices, and ultimately it will support voters in engaging with democracy.
The UK Government has recognised the challenges that have been created by the way in which functions have been transferred, together with the operation of the provisions of Schedule 7B to the Government of Wales Act, so they were content to bring forward the Order as a matter of urgency and have ensured its progress through Parliament as speedily as possible. I therefore ask the Assembly to approve it.

Thank you. Can I call Carwyn Jones to speak on behalf of the Constitutional and Legislative Affairs Committee? Carwyn.

Carwyn Jones AC: Diolch, Dirprwy Lywydd. The Business Committee referred the Government of Wales Act 2006 (Amendment) Order 2019 to the Constitutional and Legislative Affairs Committee in accordance with Standing Order 25.7(i). We took evidence from the Counsel General on the proposed Order at our meeting on 16 September 2019, and we laid our report before the Assembly on 30 September of this year. Since then, we note that the Order was approved by the House of Commons and the House of Lords on 28 October of this year. Dirprwy Lywydd, during our evidence session, the Counsel General explained the purpose and objective for the proposed Order, as well as the relationship between the Order, the Senedd and Elections (Wales) Bill and the Welsh Government's forthcoming local government Bill. We've noted the background and purpose for the proposed Order and, Dirprwy Lywydd, we are content.

Thank you. I call on the Counsel General and Brexit Minister to reply.

Jeremy Miles AC: I thank Carwyn Jones for his remarks and for the work of CLAC in relation to this Order. If the Assembly approves the Order, it will be considered next by the Privy Council at its next meeting. I expect the date for that meeting to be confirmed following the UK general election. And, in closing, can I put on record my thanks to officials in both the Welsh Government and the UK Government for enabling this legislation to be brought forward rapidly?

Thank you. The proposal is to agree the motion. Does any Member object? No. Therefore, the motion is agreed in accordance with Standing Order 12.36.

Motion agreed in accordance with Standing Order 12.36.

5. Topical Questions

We now move to topical questions, and the first this afternoon, to be answered by the Minister for Health and Social Services, is from Jack Sargeant.

Orkambi and Symkevi

Jack Sargeant AC: 1. What consideration has the Welsh Government made of NHS England’s decision to approve the use of Orkambi and Symkevi? 359

Vaughan Gething AC: Thank you for the question. The use ofOrkambi a Symkevi in NHS England is approved only through a commercial access agreement. My officials have met with, and await a formal offer from, Vertex. Given the confidential nature of our discussions, there is, of course, a limit to the comment that I can make.

Jack Sargeant AC: Thank you for that, Minister. As you are aware, I have constituents who are now travelling across the border to Liverpool and Manchester for treatment. They will be in the same building as England patients who can access this medicine. Minister, can you assure me that negotiations in the conversations you are having with Vertex are ongoing and are positive so that my constituents and the people of Wales can access these medicines as soon as possible? And, finally, Minister, have you also given any consideration to introducing an interim patient access scheme, as was the case in NHS Scotland, while the agreement was being reached on access to these two very important medicines?

Vaughan Gething AC: The Member will be aware of the letter published by Simon Stevens, the chief executive of NHS England on this matter, sent to the House of Commons's Health and Social Care Select Committee. That set out that Northern Ireland and Wales have stood alongside England in the negotiation of the agreement that has been reached. My expectation is that those terms will be honoured. I made public comment yesterday that I would sign up today to exactly the same pro-rata terms for Wales, and I wish to be able to do so. That is my commitment. There should not be a delay for any family in Wales. I look forward to a properly constructive and honest response from Vertex that allows that to take place.

Angela Burns AC: Minister, I know that you share with me concerns that, every day that passes, we have patients in Wales who aren't able to access these extremely important drugs. Now, on 25 October, you said that you and your officials were meeting with representatives from Vertex the following week to discuss details of these terms and how they might be applied. I do understand you've got company confidentiality issues here, but are you able to give us any form of update on that?
May I also ask what lessons have been learned from the length of time that it's taken to make progress on this issue, and how could things be done differently in future to ensure that we're not left behind the curve when it comes to reaching agreements on making life-saving drugs available for Welsh patients?
And finally, in terms of learning lessons, I understand that in early 2018, the company had been in discussions with NHS Wales on a portfolio proposal for all their current and future cystic fibrosis medicines. However, and I'm directly quoting, these discussions were halted in March/April, due to what we understood at the time to be a staffing issue at NHS Wales all-Wales medicines procurement. Minister, can you shed any light on that and provide assurances that such hold-ups will not happen again?

Vaughan Gething AC: On your final point, that simply isn't true. It's simply not true. Vertex understand very well the well-established appraisal mechanisms we have right across the United Kingdom for new medicines: the National Institute for Health and Care Excellence appraisal system that we sign up to, the particular appraisal systems also available in Scotland, and here in Wales through the All Wales Medicines Strategy Group. What they have done, in reaching an agreement with England, which is in the text of Simon Stevens's letter, is they've agreed to provide real-time patient data on a basis where they've agreed a price for access to be made available for every patient for whom the treatment and the condition are indicated, and they will then submit their whole portfolio, with that real-time data, to NICE for appraisal. Now that makes sense, and that was not the proposal that was ever provided here in Wales.
I am clear that we are not responsible in Wales for holding up access to these medicines. The issue is that Vertex need to do what they've committed to do, which is in Simon Stevens's letter. And that is the start and the end of the matter. No family in Wales should be put into a less advantageous position than a family across our border because of an inability to meet the terms of the deal that has been agreed. I look forward to a positive and constructive response from the pharmaceutical company.

Thank you. The second topical question this afternoon is from Angela Burns.

The Cwm Taf Morgannwg University Health Board

Angela Burns AC: 2. Will the Minister make a statement on the recent loss of 2,763 patients from the waiting list in Cwm Taf Morgannwg Health Board? 360

Vaughan Gething AC: These patients were always reported on an internal list within the health board, and their waiting times were monitored. They are now being reported on the correct referral-to-treatment or diagnostic list. Robust mechanisms are now in place to ensure the health board reports all patients correctly.

Angela Burns AC: I am very pleased to hear you use the word 'now' with great emphasis twice, because I am very concerned about this news. It's yet another failing by the management of Cwm Taf, and I truly feel sorry for the hard-working front-line staff of this health board who, week after week, see the name of the health board being tainted through no fault of their own. I'm also concerned about the confidence that patients living in this health board area have in receiving the care that they so desperately need.
Now, we are aware of the ongoing full-scale review that's been taken into maternity services, and we debated that last month and I think there are some very positive movements there, but you will know from the report that it's been cited on a number of different occasions that there are cultural systemic issues that run throughout the whole of the board's operation. I'll quote directly from the report:
'it is unrealistic to expect that longstanding issues related to culture, attitudes and behaviours can be addressed within a few months.'
So, with this background in mind, I simply ask the following three questions. Will you consider ordering or do you believe that we need to have a more comprehensive review that looks at all the services that Cwm Taf offers, and not just maternity services, if there are these systemic issues at play, and this waiting list issue could be an example of yet another? What confidence, Minister, do you have that other similar losses of data are not being replicated in other health boards? I appreciate that it was on an internal list that you didn't have eyes on, and neither did anybody else. Bearing in mind that this has occurred in one, is it occurring elsewhere? And finally, could you please explain to us what methodology is in place within your department to ensure that the data you receive from all our health boards across Wales is accurate, because good data collection is absolutely essential to help you, the Government, to plan the future delivery of healthcare? In order to be able to plan that, we need that data to be right, we need it to be the truth, the absolute truth and nothing but the truth.

Vaughan Gething AC: I'll deal with your final two points first, because in terms of whether other data issues exist, there is regular scrutiny of reported statistics by our official statistics department within the Government, and they are absolutely scrupulous in the work that they do. And where there are any caveats to data that is received, they're published as part of the statistics report. I'm sure that you and colleagues who do scrutinise those reports when they're provided will note that those caveats are occasionally provided. It's also part of the reason, because we want official statistics for the public to be able to rely upon, that we've not been able to make progress in a number of other areas, because we want to be clear that the data is reliable. I'm under pressure in a number of other areas to make official statistics available, and I've held the line about saying they'll be available when we are certain that we're measuring the same things in the same way across the country, and that is exactly what I expect here.
Actually, what happened here was that the health board themselves asked the NHS delivery unit to validate their waiting lists. That review resulted in these people being properly added to the list. So, the health board themselves said, 'We think we may have a problem, get an external body through the Welsh Government to come in and do so.' And more than that, the delivery unit's report is available on the health board's website, so the level of transparency is there now. They've recognised that this was an issue and it's been dealt with. I don't believe there is a need for a further comprehensive review into the organisation. As you know, the status of the whole organisation has been raised to targeted intervention. If there are any further steps that are required, I will report back openly and transparently, together with advice that I'll receive from the NHS Wales chief executive, the Wales Audit Office and, of course, Healthcare Inspectorate Wales.

Leanne Wood AC: This might seem like a trivial issue about a data entry error, but behind it lies consistent poor performance of even basic administrative functions. Without proper and accurate data on waiting times, we can't judge whether or not things are getting better or worse. We can't pinpoint the areas that need investment and the areas where patient safety may be at risk because of lengthening waiting times, yet poor quality of data throughout the NHS is an issue highlighted time and time again by committee report after committee report. So, how confident are you that the decisions that you make, when the data that you have shows itself to be consistently unreliable, are the right decisions?

Vaughan Gething AC: I don't accept the premise of the Member's question that the data is consistently unreliable. We're open and we're honest about the accuracy that we have in our official statistics. Those official statistics do, of course, help to inform the choices that we make and the scrutiny we have on our services. I think a blanket attack that says, 'You can't rely on data provided by the NHS' is misplaced and it's not the way that I intend to run the health service.

Caroline Jones AC: Minister, while I accept that the investigation found no evidence of clinical harm and there was no indication that Cwm Taf had been deliberately trying to manipulate the figures, this does raise serious questions about the management of waiting lists, both in Cwm Taf and across all health boards. I'm sure all of us here can list examples of patients being removed from waiting lists because they didn't respond to a letter they may never have received. Minister, will you launch a wider investigation in waiting list management across all local health boards, and will you look at how technology can be used to improve the management of hospital appointments?

Vaughan Gething AC: As I said before to Angela Burns, I don't think a comprehensive review of Cwm Taf is needed, nor indeed into waiting list management. We are, though, always looking for how to make better use of technology to help manage appointments and waiting lists within the service. Part of what I'm keen to do is to make sure that best practice across health boards is adopted and rather more uniform across our service, so people know when they have appointments and attend those appointments to make sure that we're not running a service that builds in a level of inefficiency. So, I'm always on the look-out for how we improve the service, but I'm not looking to have an unnecessary and wasteful investigation across the national health service here in Wales.

Thank you very much. The third topical question this afternoon is to be answered by the Trefnydd, and it's Leanne Wood.

The Resignation of the Secretary of State for Wales

Leanne Wood AC: 3. What discussions has the First Minister had with the UK Government on the implications for Wales following the resignation of the Secretary of State for Wales? 361

Rebecca Evans AC: We have had no such discussions.

Leanne Wood AC: I've been disgusted by the events of the last week involving Ross England. His attempt to obstruct the justice system should have prompted widespread condemnation and immediate disciplinary action by the leadership of the Welsh Tories. Instead, it was followed by the promotion of Ross England as a candidate in a target Assembly seat. We should not forget that at the heart of this story is a woman who will have to live with what was done to her for the rest of her life. There is no way that she should have had to endure a second trial.
The episode has cost the Tory Secretary of State for Wales his Cabinet job. If he did know about this incident, as is suggested by the emergence of an e-mail from a special advisor, then he must withdraw as a candidate in this upcoming election. Anyone who minimises or condones the collapse of a rape trial is not fit for public office. If it is proven that other senior Tory figures in the party in Wales and England knew of this sordid affair but did nothing, then they must also seriously consider their positions.
Do you agree with me that Alun Cairns is unfit for public office and that any inquiry should include who else within the Tory party knew of Ross England's collapsed rape trial? And will you also be making representations to the UK Government when a new Secretary of State for Wales is announced to insist that someone with a knowledge of what our country needs is appointed? While this anachronistic post exists, we can ill afford another voice for the UK Government in Wales as opposed to what is required: a strong voice for Wales within the UK Government.

Rebecca Evans AC: Well, Dirprwy Lywydd, I completely share Leanne Wood's disgust at what happened with the case and the way in which it had been handled by the Conservative Party, and Leanne, of course, reminds us very, very importantly that behind all this is a woman's life who has been impacted by what's happened and, obviously, having to go through the current situation would be extremely distressing, so I think that in all of these discussions,we have to have the woman at heart, the victim at heart.
I will say that I agree with Jeremy Corbyn's comments on this issue, and he said, whilst Alun Cairns can legally stand,
'does he have a moral right to stand as a candidate?'
He goes on to say:
'If he’s stepping down as a minister because of his involvement then I would have thought the very least the Conservative party can do is not put him up as a candidate in the next election.'
And, of course, Leanne's right again to say that we do need a Secretary of State who understands Wales, and I very much look forward to a new Secretary of State after the general election who has Wales's interests at heart, rather than the interests of the Conservative Party at heart. And it's clearly not a good thing that we're in a situation now where the only Minister left in the Wales Office is the former MP for Torbay who, I think it's fair to say, would probably have limited knowledge of the issues affecting us here in Wales.

Paul Davies AC: As I've made clear in my comments earlier today, I believe that the Secretary of State for Wales was right to resign from his role, given the circumstances. And I've also made it absolutely clear today that I think this case has been shocking and disturbing, and my heart goes out to this individual.
Now, as the Minister is aware, given today's resignation, an investigation under the UK Government's ministerial code will now take place, and that investigation will now take its course, and I very much agree. And it's important that we maintain the highest possible standards as politicians in all our parliamentary institutions, including here.
Therefore, can the Minister tell us what the Welsh Government is doing to ensure that its own ministerial code is as effective as possible so that the public can be confident in all our parliamentary institutions, and in all our Executive's institutions, to make sure that that code is as robust as possible?

Rebecca Evans AC: I thank Paul Davies for his comments, and I'm familiar with the statement that he issued earlier today, although I do feel it was perhaps a week late in coming. But I will say that the Welsh Government is constantly reviewing the ministerial code, and when additions need to be made to it, then they are done. So, Ministers are regularly issued with copies of the ministerial code, which we have to completely absorb and ensure that we, at all times, are observing what's set out in the ministerial code.

Joyce Watson AC: One of the impacts that Alun Cairns departure as Secretary of State could have is sending out a clear and substantive message to women who are considering coming forward to report rape that their trauma through a court appearance may be used to vilify them and that the case could collapse, which is exactly what happened in this case.
At a time when we all know that there is already an extremely very low rate of successful rape trials in the UK and in Wales, I think the damage that this very high-profile case can do to further diminish any prospect of women wanting to put themselves through this is extremely high. I would call on Alun Cairns to do the right thing in this case, because he stood by somebody, and it seems in the full knowledge of what that individual did, and making that woman go through a second trial. If one trial isn't enough, two trials is just beyond belief.
And there's a real danger here—and I urge everyone to be really careful in what they're doing—in identifying this victim, because that is my fear in all of this now, that somehow that could happen. We must make absolutely certain that that doesn't happen. So, doing the right thing in terms of giving up a job that he may or may not have had in a few weeks' time doesn't exactly satisfy me, and I'm sure it won't satisfy all those other women. If he was going to do the right thing, Alun Cairns, for his role in this, he ought to give up his position, because he doesn't, in my opinion, qualify to represent anybody any more in public office. Can you imagine how he's going to handle cases that might come to him about injustice in the future? Can you imagine that any woman in the Vale of Glamorgan, which he represents, would want to go anywhere near him or his party at this time? So, if the Tories—and I believe what Paul Davies said and I accept it absolutely—but if the Tories want to really say that they care, and I'm talking about the Tories in the UK and their head office, about this, then he has to go. That is the only route forward, because, unfortunately, what he's doing is damaging all his colleagues as well.

Rebecca Evans AC: I thank Joyce Watson for those comments, and what she says really echoes the words of Christina Rees, of course, who has said that
'Alun Cairns stepping down as secretary of state is far from the end of the matter, and is a shoddy halfway house that will fool nobody.'
And she goes on to say that
'He has still not explained his behaviour and still not addressed the grave issues raised by the leaked emails yesterday.'
And he
'should do the right thing—apologise, and step down as a candidate.'
But I think the most important point that Joyce Watson has raised today is the importance of ensuring that women still have the confidence to come forward and to report things that have happened to them, to ensure that there is support available for those women, and also to ensure that the women involved can always have the confidence that their anonymity will be preserved at all times.

Finally, Alun Davies.

Alun Davies AC: I'm grateful to you, Deputy Presiding Officer. Can I associate myself with remarks made by Leanne Wood and by Joyce Watson in this session of questions? The whole matter, which has been the subject of public debate over the last week, has laid bare some very, very serious issues in terms of not just the behaviour of an individual, but of the role of the Secretary of State. I hope that we and the Welsh Government will be able to pursue matters, not only to protect the place of the victim in this, but also to ensure that, wherever we have the influence to do this—I'm pleased to see the Counsel General's in his place this afternoon—we protect the court system in Wales, to ensure that women do feel able to come forward in these cases.
But this also raises significant issues about the role of the Secretary of State, and I think, for some years, many of us have felt that the role of the Secretary of State is an anachronism in this current United Kingdom. Many of us have felt, and, particularly, I speak from my experience in Government, that there is no purpose to the office of the Wales Office or the office of the Secretary of State any further.
Finance Minister, you may not be aware, but a recent hearing by the external affairs committee spent an hour and a half debating relations between the Governments of the United Kingdom with Michael Gove, just before recess, and in that hour and a half, neither Michael Gove nor any member of that committee mentioned the Wales Office. I think that speaks volumes about how the Wales Office is actually recognised in today's United Kingdom. It is time for us to put in place inter-governmental machinery that ensures that all the Governments of the United Kingdom are able to work together for the benefit of all of us in the United Kingdom, and I hope that if anything comes out of this sorry business, that will at least be one thing that does come out of this, and I hope the Welsh Government can pursue that.

Rebecca Evans AC: Thank you to Alun Davies for raising that particular issue, and, of course, the First Minister recently set out his vision, if you like, for inter-governmental relationships amongst the constituent nations of the UK. I think it is really important that that system of relationships is underpinned by the machinery that will best suit our ambitions for the way in which we will relate to other parts of the UK.

Thank you very much, Trefnydd.

6. 90-second Statements

Item 6 on the agenda is the 90-second statements. The first this afternoon is from Vikki Howells.

Vikki Howells AC: Diolch, Dirprwy Lywydd. This is a 90-second statement about an ordinary teddy bear—an ordinary teddy bear thrown away, brought to life by a spotty man and given special powers by mother nature. Yes, this is a 90-second statement about SuperTed. SuperTed, the very first commission from S4C, first appeared on Welsh tv on 1 November 1982, so this month marks his thirty-seventh anniversary. An English language cartoon featuring the anthropomorphic action hero was broadcast the following year, which, from 4 October 1984, aired to the whole of the UK.
This terrific teddy was charged with taking the S4C logo worldwide. Indeed, the series was sold to over 70 countries. He was the first outside production ever bought by the Walt Disney Company, his heroics distributed on video and broadcast to the then brand-new Disney Channel.
SuperTed was the true Welsh tv star of the 1980s. The brave bear was the creation of Welsh writer and animator Mike Young. Famously, the charismatic character was created by Mike to help his son overcome his fear of darkness. Over 100 SuperTed books were published, which sold over 200,000 copies in the UK alone. He starred in educational programming. Who remembers Super Safe with SuperTed, the road-safety animation set in Cardiff? SuperTed appeared on stage, on children's vitamins, and he was even the first shirt sponsor for Cardiff City Football Club. What a legacy. Pen-blwydd hapus.

Nick Ramsay.

Nick Ramsay AC: I have to beat that. [Laughter.] Diolch, Dirprwy Lywydd. How do you beat that?
This week marks another anniversary—the seventieth anniversary of my home town, the designation of Cwmbran as a new town, the first and only mark one new town to be built in Wales under the New Towns Act 1946.
Growing up in the 1980s in the Llanyrafon area of the town, on the western edge of the Monmouth constituency, I was very aware that the place I called home was somehow different and became fascinated by the vision of a brighter future that had inspired the postwar urban planners. That vision had itself grown out the ideas of Ebenezer Howard, the founder of the Victorian garden city movement and author of To-morrow: a Peaceful Path to Real Reform. It espoused new communities, benefiting from clean air, open space and good-quality housing, all in short supply in postwar Britain.
In Cwmbran, it also included the innovation of a fully pedestrianised town centre, with free parking, which would eventually, upon the winding up of Cwmbran Development Corporation, become the first privately owned town centre in the UK. Originally envisaged as a community of 35,000 people, Cwmbran has actually grown to nearer 50,000 people. As a result of this expansion, there are now many more people who have made the new town their home.
It has been 70 years since the then Minister of Town and Country Planning, Lewis Silkin, said to the chair of the committee of the Cabinet, Herbert Morrison:
'I think we can build a very good new town here'.
Many would say that history has proved him right. Happy birthday, Cwmbran.

7. Motion to vary the order of consideration for amendments at Stage 3 of the Senedd and Elections (Wales) Bill

Item 7 on our agenda is a motion to vary the order of consideration for amendments at Stage 3 of the Senedd and Elections (Wales) Bill. Can I call on a Member of the Business Committee to move the motion? Darren.

Motion NDM7175 Elin Jones
To propose that the National Assembly for Wales, in accordance with Standing Order 26.36:
Agrees to dispose of sections and Schedules to the Senedd and Elections (Wales) Bill at Stage 3 in the following order:
a) sections 2 to 9,
b) Schedule 1,
c) sections 10 to 28,
d) Schedule 2,
e) section 29,
f) Schedule 3,
g) sections 30 to 41,
h) section 1,
i) Long title.

Motion moved.

Darren Millar AC: Move.

Thank you very much. I have no speakers. Therefore, the proposal is to agree the motion. Does any Member object? No. Therefore, the motion is agreed in accordance with Standing Order 12.36.

Motion agreed in accordance with Standing Order 12.36.

8. Debate on the Health, Social Care and Sport Committee Report: Hepatitis C: Progress towards achieving elimination in Wales

Item 8 on our agenda this afternoon is a debate on the Health, Social Care and Sport Committee Report: 'Hepatitis C: Progress towards achieving elimination in Wales'. And I call on Helen Mary Jones to move the motion on behalf of the committee. Helen Mary.

Motion NDM7174 Dai Lloyd
To propose that the National Assembly for Wales:
Notes the report of the Health, Social Care and Sport Committee: Hepatitis C: Progress towards achieving elimination in Wales, which was laid in the Table Office on 27 June 2019.

Motion moved.

Helen Mary Jones AC: Diolch yn fawr, Dirprwy Lywydd. Thank you very much indeed, Deputy Presiding Officer. I stand here, of course, in place of our much-beloved colleague, Dr Dai Lloyd, who is currently not very well. I certainly can't hope to imitate his inimitable style. I'm sure that all Members in this Chamber will join me in wishing Dai a swift and speedy recovery, and all I can do is attempt to fill his shoes on behalf of the committee, knowing, of course, that this is completely beyond me.
I'm very pleased to take part in this debate today, on behalf of the Health, Social Care and Sport Committee, on our report on the progress towards achieving the elimination of hepatitis C in Wales. This is the third of a series of short, focused spotlight inquiries that have been undertaken by the committee, and we're all very grateful to all of those who gave evidence and, as always, to the excellent team that supports our committee's work.
The committee agreed to undertake this one-day inquiry to investigate the work currently being undertaken to eliminate hepatitis C in Wales by the target date of 2030. The World Health Organization estimates that 71 million people in the world have chronic hepatitis C infections, and of the 21,000 who live in the UK, 12,000 to 14,000 live in Wales. That's a great number of our fellow citizens affected by this condition.
We know, of course, that hepatitis C affects disadvantaged and marginalised communities, including homeless people and migrant communities particularly, with almost half of the people who attend hospital with this virus coming from the poorest fifth of society.

Helen Mary Jones AC: Key things emerged in our inquiry. We know, of course, that Wales is signed up to the World Health Organization's global health sector strategy, which aims to eliminate hepatitis C by 2030. One of the tragedies, of course, of the large number of people living with this condition is that it is now completely curable. Whilst this is welcome—the signing up is welcome—a number of witnesses to our inquiry expressed concerns about whether we will meet those targets. The committee heard that not all local health boards are meeting the targets, and that both diagnosis and treatment rates will have to increase significantly in Wales if we are to achieve the 2030 target. We heard anecdotal evidence of local health board finance directors discouraging hepatology teams from exceeding the treatment targets because of financial concerns. This approach will only result in greater financial cost in the long run, and is not compatible with Wales achieving the elimination target. It is vital that caps are not placed on local treatment targets by health boards. National treatment targets should be seen as a basic minimum floor, which health boards should be aiming to exceed.
The message from witnesses is clear—that knowledge and awareness of hepatitis C amongst the public remains low, reflected in roughly 50 per cent of patients being undiagnosed. A UK-wide poll commissioned by the Hepatitis C Trust highlighted that, of the 80 per cent who were aware of hepatitis C, less than 40 per cent knew that it affects the liver, and less than 30 per cent knew that the virus is now curable.
The committee heard that outdated information is still prevalent amongst at-risk groups, and, as such, some patients are fearful about coming forward to access healthcare, because of the difficult nature of the previous treatments. Increasing public awareness and knowledge of the virus through the development of a Government-backed awareness campaign, targeted to specialist at-risk groups, may help to reduce the effects on those who are affected by the virus. Public Health Wales told the committee that, since the Welsh Government introduced a formal policy of opt-out testing for blood-borne viruses for all those on admission to prison in 2016, the uptake of testing has increased from 8 per cent to 34 per cent. This is encouraging, and it has been a big improvement, and, in time, hopefully, Public Health Wales will reach the target of 100 per cent. However, witnesses highlighted a lack of resources for testing in prisons, and stated that, in order to make prisons HCV-free, additional resourcing and staffing is required. Recruitment and retention were also issues that were highlighted by witnesses, with some stating that lack of staff was preventing prisoners from being tested promptly.
Knowledge and awareness amongst some health professionals is an ongoing issue that must be addressed. The committee heard that patients reported less positive experiences with health professionals, such as GP and non-specialist nurses, with many saying that they had not, in fact, been offered tests. Others stated that they'd encountered low levels of knowledge of the virus from health professionals, often being given inaccurate or outdated information and advice. The Hepatitis C Trust recognises that initiatives that have been introduced to provide educational support to healthcare professionals are valuable, but says that more needs to be done. Witnesses called for protected learning time for such health professionals, and for more awareness raising. We heard that such training does not need to be time-consuming and much of it can be delivered online.
The message from witnesses was that Wales has an excellent opportunity to become the first country in the UK to eliminate this disease. However, without urgent additional action to address the uncertainty relating to the strategy and funding post 2021, the fear is that the opportunity may be lost.
So, these were our four recommendations—that the Welsh Government should produce a comprehensive, national elimination strategy for hepatitis C, with clear and ambitious targets and workforce planning built in, and provide substantial funding until the elimination is achieved. This must be done as a matter of urgency, given that the current plan ends this year, and funding for dedicated posts is only available until 2021.
Our second recommendation is that the strategy must include a targeted awareness-raising campaign to reach out to at-risk communities, and to provide additional education and training for health professionals. The Welsh Government, for our third recommendation, must write to local health board finance directors and chief executives to emphasise that the national targets for treatment for hepatitis C must be considered as a minimum and be exceeded where possible. And the Welsh Government, for our fourth recommendation, should provide additional investment to improve hepatitis testing in prisons.
We are somewhat disappointed that the Welsh Government has only chosen to fully accept one of these recommendations. We're grateful that the other recommendations have been accepted in principle. But, in fact, the Government has only agreed to write to the finance directors and the chief executives, and their response says that there are other ways to address the issues that our report raises. I will be interested to hear what the Minister has to say today, but I would urge him to look once again at our recommendations, which are strongly evidence based, and the need for a strong central lead on this is vital.

Angela Burns AC: In many ways, the hepatitis C story in Wales is incredibly optimistic. We have a disease before us, or a condition before us, that is almost entirely curable, and we are within striking distance—if we apply ourselves—to being able to wipe this out. And I think that any illness or condition that we can wipe out—polio being one of them—is something that we should all celebrate, and we can do this with hep C if we all bend our minds to the task. And, Minister, I absolutely recognise that there have been some amazing strides forward in trying to eradicate hep C, or reverse hep C, in individuals. I think there have been some good strides forward in tackling certain members of our population, certain target groups, certain ethnic groups, where there's a prevalence. There have been strides forward in reducing people who use drugs and in their contamination with hepatitis C. But, of course, it's one of those things where, as you bash down one dragon's head, up comes another.
And I found one of the very interesting things that came forward from this report is how we are beginning to see more instances of people developing hepatitis C from some of the more modern things today, like having Botox fillers, about going to sports clubs and having steroid injections. And so, Minister, what I'd like to do is ask you a couple of questions first of all around what else you're going to put in place in terms of things like syringe programmes, steroid clinics. There are 270 needle and syringe programmes throughout Wales—do we need more, how will we fund it? What about the idea of having steroid clinics, so that people can understand that there's no stigma to being able to go forward and to get that treatment? Because, of course, like all these things, it's about taking away the stigma.So, very, very positive news, but we had to do this report because it is only a job half done. And I was very concerned to see that, in this report, some of our recommendations were just to be accepted in principle. And I've kind of come to the conclusion, after my years here as an Assembly Member, that, when a Government says 'accept in principle', it is always a euphemism for kicking something out to the long grass. So, I'd just like to go through some of these 'accept in principle' comments that you have.
Now, Helen Mary has already talked about recommendation 3, which you've accepted totally, which was the one about accepting the World Health Organization 2030 target. I would like to understand why you haven't followed the Scottish one of 2024, or the UK one of 2025. I just find it very interesting—we're a small country, we can get to people quickly, and I'd like to understand your reasons here. I would like to understand how the health boards will actually deliver the hep C treatment targets that are due to be introduced in April. Can we add these targets to the NHS activity and performance summary dashboard, as a way of formally monitoring progress towards elimination? You spoke in a previous set of questions about the need to have robust data, and how you felt that data was good, and I agree with you—I think that data helps us to drive our public health policy. Are we able to add that to the dashboard? Will you commit to the production of a new Welsh health circular?
I'd also like to talk about recommendation 2, and the targeted awareness-raising campaign. Now, I know from slightly bitter experience that the Government is actually quite reluctant to undertake targeted awareness raising campaigns—I've talked to you in the past about sepsis—because you feel that national campaigns sometimes do not achieve their aims. But we've hit this barrier before, and I'd like to really understand why you will not go forward with a targeted awareness-raising campaign. It's been recommended by all the players in this area—the people who go out there and actually have to deliver these services on the ground, they believe that this is a good way forward, the committee believe it's a good way forward,professionals believe it's a good way forward, but the Welsh Government doesn't. I need to really understand and would appreciate an explanation on that.
Additional investment into prisons—now, Helen Mary has already touched upon it, but we've done quite a number of reports recently about care for prisoners, about reintegrating people into the community, about ensuring that we have minimal reoffending rates. Letting someone come out of prison feeling in good health, with a good future, a roof over their head, and a pathway forward is one of the key ways of stopping reoffending. And I simply would like to ask you to revisit your investment in prisons, because we need to get prisoner health up so that when they leave those prisons they have a better chance of staying out and a lesser chance of recidivism. Thank you.

Rhun ap Iorwerth AC: I’m very pleased to be able to contribute to this debate, even though I wasn’t a member of the health committee during the inquiry itself. This was a subject that I was very eager for the committee to look into when I was a member of it, and I very much welcome the publication of the report on this very important subject.
Now, there is a genuine opportunity for us here in Wales to achieve this simple but very exciting aim of eliminating hepatitis C in its entirety. Yes, there’s a target from the World Health Organization to eliminate it by 2030, but we could move according to a tighter timescale. Scotland and England have already set themselves a stricter target, and the Hepatitis C Trust have said to the committee that, because Wales has a relatively low number of people living in it to find and to treat, we could be the first nation in the UK to eliminate this disease. But, of course, we need a very strong strategy in order to do that and it’s very disappointing to read the conclusions of the committee that we’re not on the right course to reach the target of elimination by 2030 even, at the moment.
The belief is that potentially half of those in Wales who have hepatitis C haven’t received a diagnosis yet, partly because of the asymptomatic nature of hep C, so people sometimes receive a misdiagnosis. Perhaps people aren't aware that they're in a risk category—people who perhaps have used drugs in the past and haven't done so for decades and think that the risk has passed; potentially, users of drugs or injections to improve their image or performance in sport, even—people who don't consider that they're using injections in a dirty way, as it were, and so who don't have access to substance abuse services and are losing out on the important messages that are shared in those contexts as well.
So, I do welcome the recommendation to have an awareness raising campaign—a targeted campaign—to target those at-risk groups as well as providing training to professional health workers. It became very clear to me over the past few years that the challenge is not to treat those who already have the disease but to find those who have the disease but don’t know it. And the Government itself admits in its response to the committee's recommendations that patients are very hard to reach. So, do let us use every means at our disposal to reach them, whether by letting people know who could be at risk; using every opportunity to test; improving the testing for hepatitis C in prisons in Wales, as the report recommends; also looking at other opportunities—testing when people register with a GP, and so on. There are many ways of reaching out to people, and an awareness-raising campaign should also let people know how easy it is to treat— and how easy it is to have the test in the first place, but also how easy it is to treat hepatitis C on early diagnosis.
There is good work being done and firm foundations laid already in many ways, and I thank those within the health system and charities and so on for the major steps forward that they have taken in this regard. But we do have to ensure that there is a commitment by the health boards and the Welsh Government to move towards elimination and we should considertargets as a minimum as well, not as a maximum, so that we can treat as many people as possible and identify as many of those as possible who have hepatitis C, and that’s to save money in the long term, as well. So, as I said, there is a genuine opportunity here for us in Wales. Please do let us ensure that everything possible is done so that we don't lose out on this golden opportunity.

Caroline Jones AC: I'm grateful to the Health, Social Care and Sport Committee for their report into hepatitis C elimination in Wales. As the report highlights, around 14,000 people in Wales are chronically infected with this blood-borne virus that can lead to liver failure and cancer of the liver. It is also estimated that around 12,000 people in Wales have the disease but are unaware of it or are not actively seeking treatment.
I am pleased to see the Welsh Government actively working to achieve the World Health Organisation's target of eliminating both hepatitis B and C by the end of this decade. As the Hepatitis C Trust told the committee, Wales has the opportunity to become the first UK nation to eliminate the disease, but in order to achieve this we need a more strategic approach. The trust called for a comprehensive national elimination strategy, and the health committee agrees.
The committee’s first recommendation calls for such a strategy backed up by clear targets, workforce planning and sufficient funding. While the Minister has accepted this in principle, his response states that Welsh Government policy does not favour disease strategies because of the administrative burden. We need this strategy; guidance notes simply won't cut it. Only one health board met their treatment target in 2017-18.
Public Health Wales said that the WHO target can still be met if we have an all-Wales strategy that encompasses key interventions, relevant stakeholders and local delivery plans. This is clearly the kind of strategy envisioned by the health committee and endorsed by the Hepatitis C Trust. Therefore, I urge Members to send a clear message to the Welsh Government: Wales needs a comprehensive national elimination strategy, backed by hard targets and the money to deliver it, and nothing else will do.

Can I now call the the Minister for Health and Social Services, Vaughan Gething?

Vaughan Gething AC: Thank you, Deputy Presiding Officer, and thank you to members of the Health, Social Care and Sport Committee for their report on progress towards achieving hepatitis C elimination in Wales.
Since the introduction of new treatments in 2014 NHS Wales has treated 2,850 patients for hepatitis C, with a success rate of around 95 per cent. Access to these new and highly effective treatments has been universal and there are no waiting lists. This is a significant achievement, and yet there is much more to do if we want to eliminate hepatitis C by 2030 at the latest, as we indeed aim to do.
And I do have to pause and thank the staff, the clinical community who have undertaken the current steps we have made on hepatitis C elimination. A genuine national network of clinicians, and I've met some of those people and I am tremendously impressed by not just the work they've done to date, but by their commitment to do more and to work in a different way, as indeed the report sets out, to reach those people who have yet to take up the treatments that are available.
Key actions in relation to hepatitis C and B were originally part of the blood-borne viral action plan and are now part of the liver disease delivery plan, which is due to run until December next year. In addition, a Welsh health circular was issued to NHS Wales in October 2017, setting up a framework of actions needed at a local level to support elimination. We know what is required to successfully eliminate hepatitis C: increased testing and treatment in traditional services, in the community and in prisons. Despite its inclusion in strategies and circulars, as the committee note, investment in local services across Wales has been patchy. The introduction of formalised minimum targets—and I have heard what Members have said in the report and today—for both testing and treatment is the next step, and it will require further investment by local services.
A key performance indicator for testing and substance misuse services was introduced for area planning boards from April 2019. As a result, we have already seen testing rates increase by over 50 per cent compared to the same period in 2018. Health boards will be sent a formal minimum treatment target as part of the NHS delivery framework for next year, 2020-21. This will encourage health boards to invest in effective and sustained outreach services in order to engage with individuals who are not currently in contact with traditional services. It is these outreach services that are needed rather than, in my view, a national awareness campaign. People are unlikely to see and be motivated to take part in new forms of treatment by a traditional national awareness campaign.
Formal minimum treatment targets will require health boards responsible for the health of our prisoners to consider the effectiveness of the current opt-out testing arrangements. And I was recently delighted to hear that the micro-elimination of hepatitis C had been achieved in Swansea prison. That of course now needs to be sustained in Swansea prison, and other health boards need to look at what is required to make this happen within the prison population in their own areas.
To support the local action required, a wider range of national actions are being progressed. The hepatitis C re-engagement exercise has already resulted in 41 patients commencing treatment. This programme will continue checking old patient records and contacting patients for testing well into next year. The roll-out of the testing in community pharmacies has been slower than expected, but we'll continue to drive that agenda forward to ensure that testing and treatment is delivered in community pharmacies across Wales.
I'm happy to commit on behalf of the Welsh Government to provide annual updates, guidance and instruction to health boards where necessary. I am confident that the actions outlined will put Wales back on track to achieve elimination by 2030 at the latest, as I recognise the committee wants to see as well.

Angela Burns AC: Will you take an intervention, or have you finished?

Finished, sorry. Can I call Helen Mary to reply to the debate?

Helen Mary Jones AC: Thank you, Deputy Presiding Officer, and I'm grateful to everybody who's participated in the debate. Angela Burns is right of course to highlight the new challenges, people who may not feel that they fall into the traditional groups of people who may be vulnerable to the virus. I also very much want to associate myself with what she said about the principle of 'accept in principle'. I think many of us who work on the committees in this place would rather, where it's appropriate, that if the Government doesn't fully agree with our recommendations that they simply disagree, but that's a matter of course for the Minister himself.
I think what Rhun ap Iorwerth said about being ambitious about targeting sooner, that because we are a small country, because we have responsive health services, we ought not to be content only to meet the 2030 target, but we should look to be more ambitious. I would urge, on behalf of the committee, the Welsh Government to look again at that.
Similarly, Caroline Jones's point about the need for a national strategy, I hear what the Minister says that strategies can be bureaucratic, that people can end up spending more time dealing with responding to the strategy than they do in actually sorting out the problem, but the evidence that came before us is that a particular strategy for this condition is needed, because if it's put in with a whole load of other conditions, we were told that it would get lost.
I want to draw on a particular point in the Government's response to our recommendation about a national strategy, and that is with regard to the specialist posts. The Minister's response says that he can't guarantee that the specialist posts will continue, though he understands that they will be needed. Of course, I take the point that the Minister doesn't know what his budget will be in 2021, but it is extremely important that those specialist and innovative posts are maintained, and I hope that this Assembly can send the Minister a very clear message and ask him to prioritise that.

Joyce Watson took the Chair.

Angela Burns AC: Will you take an intervention?

Helen Mary Jones AC: I will very happily take an intervention.

Helen Mary Jones AC: Thank you very much indeed, because I take your point absolutely about the specialist posts, and I do hope that the Minister hears that, because of course one of the things we heard in our evidence very strongly was that GPs themselves—and this was from GPs and the Royal College of General Practitioners—were saying that they were missing the signs of hepatitis C. Patients were saying that, although they presented with all the symptoms, they weren't being picked up. And unless we have these specialist posts in place, I fear that more people will become missing.

Helen Mary Jones AC: I agree that that is a serious risk. This brings me on to the point that I wanted to make to the Minister about our recommendation 2, which was about targeted awareness and about training for professionals. Now, we weren't asking, Minister, for a traditional awareness campaign. We know it wouldn't reach the right people, and perhaps we can keep under review whether the approach that the Minister has suggested will be effective. But the Minister says in his written response that education and training for health professionals is already available. Well, the evidence that was placed before us, as Angela Burns has already said, made it very clear that that education and training isn't sufficient in itself. And, again, I urge the Government to keep this under review.
The Minister is absolutely right to say that we've made significant achievements, and this was a message that was very clear to the committee, and that staff have done some amazing work. But the truth is that we need to be more ambitious if we are to eliminate this condition, a condition that we know that we can eliminate. And the committee will be keeping a close eye on the Government's progress in delivering on that target, while continuing to urge them to be more ambitious and to set a more ambitious one.

Joyce Watson AC: The proposal is to agree the motion. Does any Member object? The motion is therefore agreed in accordance with Standing Order 12.36.

Motion agreed in accordance with Standing Order 12.36.

9. Debate on Petition P-05-854—Make Learning Disability training mandatory for hospital staff

Joyce Watson AC: We're moving on now to item 9, a debate on petition P-05-854, 'Make Learning Disability training mandatory for hospital staff', and I call on the Chair of the committee to move the motion. Janet Finch-Saunders.

Motion NDM7177 Janet Finch-Saunders
To propose that the National Assembly for Wales:
Notes the petition 'P-05-854 Make Learning Disability training mandatory for hospital staff' which received 5,654 signatures.

Motion moved.

Janet Finch-Saunders AC: Thank you. On behalf of the Petitions Committee, thank you for the opportunity to introduce this debate today. This is the eighth petition to have been referred for a Plenary debate, having received more than 5,000 signatures, since the process was introduced in March 2017. The petition, 'Make Learning Disability training mandatory for hospital staff', was submitted by the Paul Ridd Foundation, having collected 5,654 signatures. The foundation was established in 2016 by the sister and brother of Paul Ridd, who died whilst in Morriston Hospital in Swansea in 2009, at the age of 53.
Now, I want to start by describing some of the background to this petition and, in particular, to speak about Paul Ridd. From birth, Paul had severe learning difficulties, which meant that he spent most of his life in care. On 31 December 2008, he was admitted to hospital with a perforated bowel. This required major emergency surgery and, following the operation, he spent three weeks in intensive care, under sedation. Following this, Paul was moved to a general ward and his sedation was reduced. It was at this point that his family describe a deterioration in the care he received. They also felt that he was moved prematurely. They have referred to a number of issues that arose in relation to his care on the general ward. These included a loss of his notes on arrival, delays in administering medication, long periods with no observations taken, and a lack of recognition given to signs that his condition was deteriorating. This is heartbreaking and sadly serves as a reminder of health cases most of us here will be handling for constituents today. But, underlying all of these concerns is the petitioners' view that medical staff did not take Paul's learning disabilities into account or listen to the concerns and observations raised by his family and carers. Sadly, Paul died in hospital on 23 January 2009.
Now, two years after his death, the Public Services Ombudsman for Wales published a report into complaints made by Paul Ridd's family. This upheld many of their concerns and concluded that Paul's nursing care on the ward had been very poor and, when combined with his clinical care, had produced an unacceptable level of treatment. A coroner's report, following an inquest in 2013, found that he had died from natural causes that were contributed to by neglect.
So, I certainly wish to offer my condolences to Paul's family, at this point, for their loss, and also to commend them for the work they have done since then to ensure that lessons are learnt. I am sure that their commitment to improving the care that people with learning disabilities receive in hospitals will already have helped countless other individuals.
I will now move on to the specifics of the petition. Now, as I have mentioned previously, Paul's sister, Jayne, and brother, Jonathan, established the Paul Ridd Foundation in 2016. Their work has already led to the development and launch of a pathway care bundle for people with learning disabilities in 2014, with some support from the Welsh Government. This is designed to help hospital staff ensure that people with learning disabilities do receive a fair and equitable service when they visit hospital. However, when the Petitions Committee first considered the petition in January, the petitioners described concern over difficulty ensuring that the care bundle is implemented consistently throughout Wales. Key to achieving this, they argue, is for learning disability awareness training to be made mandatory for staff in hospitals, as outlined within their petition. So, this training would start from the principle of what a learning disability is—an understanding that the Paul Ridd Foundation contend is frequently missing amongst staff in practice.
Training should stress the importance of delivering an equal standard of healthcare to people with a learning disability, and to inform all staff of the need to make necessary adjustments to services, so that they are responsive and flexible to the individual needs of patients. It is this type of tailored care that they consider was lacking when their brother was receiving hospital treatment in 2009.
As well as the benefits to the individual patient, the foundation stresses that providing this training will assist staff to perform their roles to the best of their ability, and to do so for all patients in their care. They describe their view that training would complement the existing pathway care bundle by ensuring that all NHS staff are informed about its existence and what it covers, and that this would help improve what they describe as 'sporadic awareness' of its existence at present.
The foundation describes successfully delivering training of this type to over 1,000 learning disability champions, many of whom believe that the training should be mandatory for all staff. I am also aware, as I am sure other Members are, of other families of people with learning disabilities who are concerned about the care that their loved ones receive from the health service.

Mike Hedges AC: Will you take an intervention?

Janet Finch-Saunders AC: Yes.

Mike Hedges AC: The most important thing is that it's not online training followed by a multiple choice test that people can take a number of times. People have to be properly trained.

Janet Finch-Saunders AC: Thanks to my colleague Mike Hedges AM for his intervention. And that is the point and principle, really—one of the main points and principles behind this petition.
Now, in advance of this debate, I have received correspondence from others supporting the petition, and I have been seriously saddened by reports, such as that after the death of an individual with severe learning disabilities who could not speak, an inquest allegedly found that the individual had not received appropriate care and treatment, and that health board staff did not respond appropriately or with sufficient urgency to the individual's presentation.
The Petitions Committee has also considered developments in England, where the outcome of the consultation into proposals to introduce mandatory learning disability and autism training for health and care staff is still awaited. We could await for the publication, but I ask Members here today—and this is what the petitioners are asking—why should Wales not lead the way? We need to see progress here. Currently, it is estimated that one in four healthcare professionals have never had training on learning disability or autism.
I must acknowledge the statement issued by the Minister for Health and Social Services earlier this year that £2 million has been made available over the next three years to improve NHS services for people with a learning disability. However, money alone will not achieve the core aim of this petition: making learning disability training mandatory for hospital staff. Similarly, whilst the Paul Ridd Foundation value the Minister's commitment to the Improving Lives programme, they have reiterated that mandatory training will be key in delivering the outcomes of the healthcare issues in that programme.
I will leave the final word in my remarks today to the Paul Ridd Foundation. Their purpose since his death has been that another family would not have to go through the same experience when in hospital and to ensure that all staff are supported to see the person, not the disability. It is considered that making learning disability training mandatory for hospital staff would go some way in achieving this. Diolch yn fawr.

David Rees AC: Unfortunately, deep concerns still exist today about health inequalities and the disproportionate numbers of potentially avoidable deaths of people with a learning disability. I'm sure that many of us can reflect upon a constituent's case that highlights these concerns. It's something that worries me deeply, in that, here we are, in 2019, still having to address such inequality being experienced by people with learning disabilities.
Our health and care system needs to do much more to give people with learning disabilities the good-quality health and social care that they ought to expect as a right. People with a learning disability can experience hospitalisation, life-threatening illnesses and even premature death when unable to access health services for even the most routine conditions or ailments. It remains a stark fact that people with learning disabilities die on average 20 years earlier than the general population and that they continue to experience significant disparities in the quality of care and support they receive, as well as the outcomes they can expect. This is unacceptable in a twenty-first century Wales.
Llywydd dros dro, as we've already heard, one particular case that we should be aware of is that of Paul Ridd, who lived in Baglan, in my constituency, whose life may have ended in 2009, but whose story lives on and is key to this call for mandatory training for all health and care workers in every health and care setting. Paul's sister is in the gallery today, and she, along with her brother, decided to take action following their loss of Paul to address the fact that the lack of training and ignorance of his needs were considered as contributory factors in his death. And as already pointed out by the Chair of the committee, they established the Paul Ridd Foundation and have campaigned tirelessly for improvement in awareness and understanding by hospital staff of the needs of individuals with learning disabilities, so that they can provide a level of care no different from that of other patients. They have produced training material, created a traffic-light system, logos, which will be used on patients' records, hospital passports, and a pathway care bundle, working with professionals. Those logos are not new—we've seen them with dementia patients: the butterfly logo. They're already in existence for other conditions. This is nothing new in reality, but it's ensuring that it addresses the needs of people with learning disabilities.
Now, the pathway care bundle was launched in 2016 in Morriston Hospital and I was privileged to attend that launch. It sets out seven key steps—key steps, which, if followed, will ensure that all patients with learning disabilities will experience the level of care that we expect for all patients and for our loved ones if they attend hospital. And I was pleased that ABMU—as it was then, Swansea Bay as it is now—drew up a comprehensive programme of learning disability awareness training for key nursing and clinical staff, which included appropriate recognition of the role of family—and that's crucial here—carers and advocates in providing vital information to staff, helping to make prudent decisions about care. And Paul's family have been pivotal in ensuring this has been rolled out, and I congratulate them on their part in this.
However, as has been pointed out, learning disability training is not mandatory, and if it does take place, I've been made aware that it generally forms part of an induction session. What I don't know is: was that half an hour, 10 minutes? Who knows? It's very simple to say it's in the induction, but it's actually, 'What does the training entail?' That's crucial. Now, is this acceptable? No. It's not acceptable. Learning disability training should be mandatory and more. It should be refreshed, not on a one-off but on a regular basis. So, all staff—and I use the words 'all staff'—working in the hospitals need to have the correct training to ensure a smooth experience for patients with learning disabilities and their families. It must not be, as my colleague pointed out, e-learning-based or even classroom-based, it must be interactive with individuals and use the collaboration of organisations that work with people with learning disabilities in that process. And as I said, all staff, from the point at which they enter the healthcare system—whether it's a receptionist in a doctor's surgery, a receptionist in a hospital, or the nurse in an A&E unit—from that point they enter to whomever they meet in that journey through that system, they need that training. Different levels of training, I understand, but everyone needs to understand that training so that patients entering our hospitals are treated with the dignity and respect we would expect for everybody. And it is a challenge, but it's a challenge we must meet.
Now, in this Chamber, we should be determined that everybody who has a learning disability receives the high-quality care that meets their needs and their expectations, and which results in positive outcomes for that individual. In life, like many others, Paul had a right to be listened to and their needs understood, but tragically, this was not always the case. We owe it to their memory that people with learning disabilities are supported to live healthy and happy lives. They deserve nothing less.
We must deliver a system that ensures that patients and service users receive safe, effective and dignified care, and that those who provide care have the knowledge, skills and behaviours to support people with learning disabilities. I am aware that England yesterday announced they will actually be doing the mandatory training. I hope, therefore, that Wales will follow suit and ensure that training is training and not simply a half-hour exercise so it can be a tick box.

Mark Isherwood AC: The estimated learning disabled population in Wales of 70,000 people are at a greater risk of physical and mental ill health, have a lower standard of health and a greater risk of developing poorer health, are twice as likely to access secondary care in an emergency, and die, on average, decades before the general population. Thirty-eight per cent of these deaths are avoidable—more than four times the rate of the general population—with hundreds more dying of avoidable deaths in secondary care. Yet, hospital staff do not receive focused learning disability training and are therefore not equipped to deliver the level of care required.
Mencap Cymru and the Paul Ridd Foundation are therefore right to call for mandatory learning disability training for hospital staff and to highlight the result of the Bangor University MSc research, funded by Mencap Cymru, which supported the hypothesis that improvements were seen in the attitudes held by hospital staff members towards patients with learning disabilities, following their participation in the learning disability awareness sessions. This is particularly topical, where a report by the UK Parliament's joint committee on human rights said last Friday that mental health legislation must be overhauled to stop the horrific inappropriate detention of young people with autism and learning disabilities, and where the UK health Secretary announced yesterday that thousands of mental health patients with learning disabilities and autism will have their care reviewed over the next 12 months, and each will be provided with a hospital discharge date or plan to move closer to home.
We must hope that the Welsh Government will participate fully in this on behalf of affected patients from Wales. The nature of an individual's learning disability varies widely and will affect the kind of support they may require. Many people with a learning disability will have a reduced ability to cope independently in a variety of situations, including health services.
The Paul Ridd Foundation and Mencap Cymru recommend that all hospital staff working in a role that contributes to the health outcomes of people with a learning disability or autism should have the proposed training. As Mencap Cymru state, however:
'Autism is not a learning disability'.
And as the National Autistic Society state:
'Autistic people can have different "degrees" of learning disability…. Some people will be able to live fairly independently—although they may need a degree of support to achieve this—while others may require lifelong, specialist support. People with a diagnosis of Asperger syndrome do not usually have accompanying learning disabilities, but may still have specific learning difficulties, such as dyslexia.'
As I'm told daily by people with direct lived experience—the real experts—we must ensure that the learning disabled and autism communities are given a direct role in the design and delivery of services, moving beyond awareness to understanding, acceptance and empowerment. In other words, instead of making them fit into a model designed by people who don't think like them, we must become more flexible in the delivery of services and see the world through their eyes.
As the Paul Ridd Foundation and Mencap state 'we need: more than E-Learning,' as we heard. Content and training materials should be co-produced with people with a learning disability or autism and their families. Unconscious bias and implicit attitudes need to be addressed, and the Mental Capacity Act 2005 and Equality Act 2010 must also be central to any training. And we must remember that that Equality Act 2010 requires that service providers must think ahead to take steps to address barriers that impede disabled people. In doing this, it is a good idea, it says, to consider the range of disabilities that your actual or potential service users might have. You should not wait until a disabled person experiences difficulties using a service. That's the law.
However, the regulation of health professionals, as opposed to social work professionals, is a matter reserved to the UK Government under the Government of Wales Act, which means that the Welsh Government could find itself in breach if it introduced a mandatory requirement for training of health professionals other than generic equality training. The Welsh Government could instead adopt the approach consequently taken in Paul Davies's defeated Autism (Wales) Bill, and make suitable learning disability or autism training available for health professionals.
The good news, however, as was briefly referred to previously, is that yesterday, following a public consultation, the UK Government announced its intention to introduce mandatory learning disability and autism training and its commitment to work with all professional bodies and the devolved administrations to agree a common core curriculum. Hopefully, therefore, we have a way ahead.

Rhun ap Iorwerth AC: I'm pleased to be speaking in this very important debate, a debate that highlights just how far, I think, society still has to go to work for people who have brains that work differently. The petition highlights just one case in which the neglect, ignorance and lack of training for staff about learning disabilities have resulted in an avoidable death, but it's one case that's part of a wider pattern in which people with learning disabilities, autism or other neurological divergence can experience worse health outcomes, despite comprising a significant proportion of the population.
In many health settings, we know that conversations can be structured in a way that misses the diagnosis of conditions. Most neurotypical people will provide relevant information that goes beyond a direct answer to a question. For example, 'Have you vomited?' Answer: 'No, but I feel very, very sick,' whereas perhaps an autistic person may just provide a literal answer to the question, 'no,' which can lead to incomplete communication of symptoms and, as a result, missed or delayed diagnoses, and, for somebody who is non-verbal, that becomes even worse. Indeed, rates of almost every type of physical and mental health problem are significantly raised in groups of people with autism and/or learning disabilities. Evidence suggests that the way in which people are asked for their symptoms, asked to describe their symptoms, has a significant effect on diagnosis.
But rather than move to address this by increasing training, we've actually seen a reduction in many cases—for example, the reduction in the learning disability post provided in Bangor. The Nursing Times reports more widely that almost half of the universities with pre-registration learning disability nursing courses have discussed terminating their programmes next year due to student recruitment difficulties, which is frightening.
Of course, it's not just down to those students who are in the learning phase of their career. We need also to be ensuring better professional development for existing nurses, except, of course, thatisn't happening. Our nurses are overworked, and we know that they lack protected training time. In Betsi Cadwaladr, of course, the proposal is that nurses will now lack protected lunch breaks as well—a scandalous lack of respect for the nursing profession that will be the topic of a Plaid Cymru debate later this afternoon.
But we have to ask ourselves why is it that we are continually seeing the role and training provided to nurses being less and less respected, despite the consequences that are highlighted here. It has to be said that this is another strong argument as to why we need neurodivergence to be a protected characteristic in equalities legislation, as, frankly, the situation currently is not good enough. I sincerely hope that the petition succeeds in making the Government take this issue far more seriously.

Helen Mary Jones AC: I want to introduce this Chamber to a constituent of mine, Mr Heddwyn Hughes. I first met Heddwyn and his family a good number of years ago, when they were experiencing some difficulties with the funding of his care placement in Mynyddygarreg and they came to me for some support and advice. I would have been perfectly happy just to talk to the family, but the family said to me, 'Heddwyn is your constituent, as well as us. Come and see him. Come and meet him.' And I was very pleased and proud to do so. He was a gentleman with severe learning disabilities that he'd had from birth. He'd been in care from the age of nine in a range of homes, but he was surrounded by a loving family and living in the community where he belonged.
We successfully resolved the funding issue, and Heddwyn continued to be funded by the local health board, as was appropriate, and I hadn't heard from his family for a very long time until this week. I couldn't instantly remember the case when I saw the e-mail, and when I opened the attachment and saw Heddwyn's smile, then I remembered who it was.
Heddwyn died in May 2015 in a care home run by the local health board. The jury at his inquest could not determine the cause of his injury, though he died having had a broken neck. But his inquest concluded that he did not receive appropriate care and treatment by the medical staff in his care home, that they did not respond appropriately to his presentation—he was a gentlemen who was physically able to move before the injury; suddenly, he could not move from the neck down. Now, if that happened to somebody who was neurotypical—if it happened to one of us—you would instantly call an ambulance. The staff decided not to do that in this case, they gave inappropriate information to the GP when the GP arrived, and the GP struggled to diagnose his condition. Eventually, he was sent to hospital with complete loss of use of all his limbs. But the hospital did not diagnose his broken neck for 10 days. And the reason given for that was, 'He couldn't tell us what had happened.' Of course he couldn't tell them what had happened—he wasn't able to communicate verbally.
There's a whole lot else that I could say about this case. But the family came back to me on this issue because they believe that the healthcare staff were doing their best, that they hadn't had the appropriate training to understand his needs, to understand his communication needs, and that they weren't able to provide the care that he needed because they did not know how—not because they didn't wish to, not because they didn't care, not because they weren't good people, but because they did not know how.
The family asked me—. They were here today and they asked me specifically to raise his case here as an example of a gentleman who had many years of life ahead of him, whose broken neck could have been treated and he could have continued to live a full life, even though he may have had a physical disability as a result of it. They lost him eventually to pneumonia, because he was not treated for a broken neck for 10 days.
I want to associate myself with everything that has been said in this Chamber today about this being an issue of equality, of people's right to treatment. Heddwyn was my constituent. His family are my constituents. He was a gentleman loved in his community, who had a full life. He lost that life because the staffdid not know how to care for him. This is intolerable in twenty-first century Wales. And we will not solve this issue by sitting staff in front of a computer for 25 minutes—we will not. Effective equalities training—and many of you know that I worked in this field in the past—has to be achieved both by learning the law and learning the guidance and learning the appropriate thing to do, and then by having our own preconceptions, our own ways of thinking, challenged.
I know there are complications, as Mark Isherwood said, about mandating training, but I can't imagine that there would be any member of healthcare staff in this country of ours who would not want to receive that training if they were given protected time to do it. So, please, I really hope—and I'm very grateful to the Petitions Committee for bringing this to us today—please, please, for Heddwyn, for everybody else that we've heard about today, please let us have our staff properly trained so that our fellow citizens will not be put in this position again. Heddwyn and his family, all the families affected by this, deserve to be taken seriously, and our staff need and deserve the training that they need to protect and support patients like Heddwyn.

Caroline Jones AC: I'm pleased to speak in this debate today, and thank the Petitions Committee for bringing it forward, and I also thank the family and friends of Paul Ridd for bringing forward the petition also. Mr Ridd's tragic death was a travesty and clearly highlighted serious failings in our NHS when it comes to patients with a learning disability. A lack of training and awareness of learning disabilities were highlighted as a contributory factor in Mr Ridd's death.
Thanks to pressure from Mr Ridd's family the Welsh Government issued specific guidance on improving care for people with a learning disability, acknowledging that communication and an understanding of these needs is of paramount importance. However, the guidance doesn't go far enough, and I and many of us across this Chamber campaigned for an autism Act, which would have required all health and care staff to have autism and learning disability training.
The Welsh Government rejected the need for such an Act, which I would still maintain is very necessary. However, in the absence of an autism Act, we should, at the very least, comply with the wishes of Mr Paul Ridd's family, friends and the nearly 5,500 Welsh people who signed this petition. Learning disability training for all staff working in health and care should be mandatory.
I commend the efforts of Mr Ridd's family and pledge the support of myself and my party to making their wish a reality. We can't bring back their brother, but we can ensure that no one else's brother or sister, parent or child die of neglect because of inadequate training. I urge colleagues to support the petition before us today and hope the Welsh Government will commit to implementing the wishes of Mr Ridd's family. Thank you.

Joyce Watson AC: I call on the Deputy Minister for Health and Social Services, Julie Morgan.

Julie Morgan AC: Thank you. And, firstly, I would like to thank the Paul Ridd Foundation and the Petitions Committee for bringing forward this petition today, and I was very pleased to meet Paul's sister and brother and other members of the foundation earlier this afternoon. Today's debate does provide me with the opportunity to explain our plans to embed a comprehensive national education programme across the whole of the NHS in Wales, not just in hospital settings.
We're committed to ensuring that those affected by a learning disability lead an active and fulfilling life within a caring and stable environment, where the challenges they face are understood and society does all it can to address inequalities and potential hardships.
What happened to Paul Ridd was a tragedy for all involved, and I would also say the same for Helen Mary's constituent, and, for some time now, the NHS in Wales and the Welsh Government have committed to ensuring lessons are learned and history does not repeat itself. I am confident that we can achieve this, with great strides being taken in awareness and understanding of the issues facing individuals with a learning disability and how these issues can be addressed.However, we do recognise that sometimes progress has been slow and more needs to be done.
The Paul Ridd Foundation have done an exemplary job in going into hospitals and educating staff on how to help those with a learning disability. Sadly, Paul's family know only too well why it's so important for all NHS staff to understand the issues faced by individuals with a learning disability, and I welcome their continued contribution as we develop a framework for the NHS in Wales.
The landmark Learning Disability: Improving Lives Programme received Cabinet and cross-party support when launched in June 2018. This sets out our commitment to improving the lives of those affected by a learning disability. The programme contains 24 actions across the whole of Government, aimed at addressing issues that affect those with a learning disability. It covers early years, health, social care, housing, employment, education and transport. We have provided, as has already been mentioned today, additional funding of £2 million to support the NHS to deliver the health actions in the programme.
Implementing these actions will improve the consistency and quality of learning disability services in both primary and secondary care for children, young people and adults. One particular action is to ensure that reasonable adjustments are made in hospital settings to support people with learning disabilities and their families to access mainstream NHS services. This is why an education and training framework for all staff is so important. Our approach is to ensure that learning disability awareness training is fully embedded into the core training programme for all staff as part of the health board's mandatory equality and diversity training, supported by more in-depth targeted training for staff in key roles. I know that the foundation are anxious that this training should be mandatory and I can confirm that it will be.Our approach will ensure that staff are fully aware of the issues and able to deliver the best possible services for individual patients and their families.
Pre-registration education for all health care professional groups includes an element relating to dealing with vulnerable groups. The nursing profession has specific provision in the core curriculum on learning disability and includes a placement in a learning disability service. However, the approach varies across the health professions, with some professional groups receiving general awareness raising as part of wider training provision around equality and diversity, and of course some healthcare professions will have qualified prior to the inclusion of any sort of awareness raising training. So, we're committed to putting in place a comprehensive framework of education and training for all NHS staff to ensure that everyone working in a health care setting—

Helen Mary Jones AC: Will the Minister take an internvention?

Julie Morgan AC: Of course.

Helen Mary Jones AC: I'm very grateful. Can we ask you to ensure that that awareness training will include some element of face-to-face training as well as the very useful stuff that can be done online? Because I know from your previous work that you understand as I do that attitudes need to be challenged in a way that a computer can't.

The Deputy Presiding Officer (Ann Jones) took the Chair.

Julie Morgan AC: Yes, and I will be going on to refer to that later on. We want to ensure that everyone working in a healthcare setting has the appropriate skills and training necessary for them to make the reasonable adjustments that ensure individuals with a learning disability are treated effectively and receive high-quality care appropriate to their needs.
So, led by the University of South Wales, work is under way on developing a new three-tier framework approach to embedding training within NHS Wales. The framework will take a tiered approach. Tier 1 will be a national general awareness training programme for all staff. This will be embedded in health board equality and diversity training programmes, and this is effectively mandating training. Tier 2 will comprise enhanced training for those staff with regular contact with individuals with a learning disability, and tier 3 will comprise a comprehensive education programme for staff with frequent specialised contact. So, everybody will get the basic training and there will be more specific training for those that have more intensive contact.
The university will work collaboratively with the NHS, with families and third sector stakeholders, including the Paul Ridd Foundation and All Wales People First, to develop the framework, and it will be rolled out in full from spring next year. And I know that the foundation—and they've made the point to me very strongly—believes that the training should involve people with learning disabilities themselves in an interactive way, and I believe that this should be achieved, and the Paul Ridd Foundation will be part of the group that will plan the framework and will be there to see that these important elements are included in the framework.
And, in fact, the approach we are taking goes further than the petition requirement. Training will be mandated for all NHS staff working in primary and community care settings, as well as hospital settings. And we will also be exploring opportunities to establish the framework across social care settings. We are also exploring the extent to which the new three-tier framework could be applied for autism as well as for learning disabilities. Training standards for professionals working with individuals with autism will be developed. In addition, a universal passport is being developed with service users, families, carers and NHS staff. The passport describes the issues affecting the individual so that mainstream NHS services can respond appropriately to their care needs. This will be a Wales-wide model and will be introduced in parallel with a framework of education and training.
So I hope that, today, I have reassured the Paul Ridd Foundation and the wider learning disability community of our intention and commitment to establish as quickly as possible a national comprehensive training programme for NHS Wales, which will include mandatory training and which will include interaction with people with learning disabilities, because I agree that that is one of the most powerful forms of interaction.
Paul's family asked me today whether the new framework could be named after their brother, Paul. I think that would be an excellent idea and a lasting memory of Paul Ridd.

Thank you. Can I call on Janet Finch-Saunders to reply to the debate?

Janet Finch-Saunders AC: Thank you, Deputy Presiding Officer. Well, first off, I would like to thank the Deputy Minister for what I think has probably been one of the most positive responses that I've heard in this Chamber since I've been an Assembly Member. You've listened, you've acted and I think you've gone one step further, really, to actually make this petition very meaningful. And it really only remains for me to thank the Paul Ridd Foundation and, indeed, Paul's family, again, for bringing this petition forward and for their work—hard work—in seeking improvements to care for people with learning disabilities.
Of course, the Petitions Committee will now consider the petition again in light of all the contributions made. I think that the contributions made from fellow Assembly Members here today again made it very evident that we do take petitions very seriously indeed, and that this one in particular was very, very important. We will obviously discuss your response during committee, but on behalf of the committee, I would like to thank every Member who has stayed for this debate today, and huge thanks again to you, Deputy Minister. Diolch yn fawr.

Thank you very much. The proposal is to agree the motion. Does any Member object? No. Therefore the motion is agreed in accordance with Standing Order 12.36.

Motion agreed in accordance with Standing Order 12.36.

Before I move on to the next item, can I just say we are aware that there is some sort of high whistle or technical noise? We are investigating it, but if it is going to get any worse or carry on for any length of time, we'll have to see what we can do, but we'll carry on as long as we can.

Jenny Rathbone AC: Deputy Presiding Officer, it is quite intense. It's very difficult to listen to the debate while it's there.

All right. Okay. I'll adjourn for five minutes, then, to see if we can find out exactly what is happening. We'll adjourn and I'll ring the bell and give you a minute's notice to come back in. Thank you.

Plenary was suspended at 16:39.

The Assembly reconvened at 16:54.

Okay, then, we'll reconvene, and thank you very much for your patience on that. I think we've hopefully found the solution to that.

10. Plaid Cymru Debate: Access to Health Services

The following amendments have been selected: amendment 1 in the name of Rebecca Evans, amendment 2 in the name of Caroline Jones, and amendments 3, 4 and 5 in the name of Darren Millar.If amendment 1 is agreed amendments 2, 3 and 4 will be deselected.

So, we're going to move on now to item 10, which is the Plaid Cymru debate on access to health services, and I call on Helen Mary Jones to move the motion. Helen.

Motion NDM7178 Rhun ap Iorwerth
To propose that the National Assembly for Wales:
1. Expresses concern with the lack of access to basic medical services, including GPs and NHS dentistry, in many parts of Wales.
2. Calls for the recruitment and retention of additional medical staff to ensure appropriate access to health services across Wales.

Motion moved.

Helen Mary Jones AC: Thank you very much, Deputy Presiding Officer. We want to focus in this debate—I'm pleased to move the motion, tabled in the name of Rhun ap Iorwerth—we want to focus in this debate on access to community care services, community health services.
Now, I don't feel I have to spend terribly long in this Chamber setting out the fact that we have a real problem. The number of GPs, for example, has fallen since 2010 from 1,991 to 1,964 at a time when demand has gone up. We know thatwhen it comes to access to the dentistry service—and I know my colleague Siân Gwenllian will have more to say to this later in the debate—only one in six dentists in Wales are taking on new national health patients at the moment.
When the health committee recently reported on community nursing, we were shocked to discover that we, in fact, don't know how many district nurses we've got. We don't know what the state of community nursing is in Wales, because the data isn't there. And we all know, in this Chamber, from our constituency and regional postbags, and many of us from our personal experience, of people waiting weeks and weeks to see a GPor to access other services in community services and GP surgeries for non-urgent appointments. And we also know that there are huge disparities in services across Wales, and that poorer communities are disproportionately badly served—

Huw Irranca-Davies AC: Will you give way?

Helen Mary Jones AC: I will happily give way, yes.

Huw Irranca-Davies AC: I hope I didn't intervene too early, but, actually, I agree with the point you just made, which is that one of the issues is the lack of uniformity, because I've got patches in my constituency that are exceptionally well provided for in terms of primary care, but also that engagement with community healthcare teams. There's some amazing work going on. But then I have issues in some areas with dentistry accessibility, and there doesn't seem to be no rhyme nor reason.

Helen Mary Jones AC: I think that's a very valid point that Huw Irranca-Davies makes, which is that in a country the size of Wales, 3.5 million people, we should be able to achieve some consistency. I don't know if it's the case in his constituency, but it's certainly the national experience that the poorer the community, the more poorly it is likely to be served. It's not always the case, and we get excellent practice serving some of our poorer communities, but it's not good enough.
We had a discussion recently in First Minister's questions, raised by my colleague Adam Price, about the broken manifesto pledge to require GP surgeries to open at evenings and weekends. We were told that there was no demand for it. I find that incredibly hard to believe. But also we know—be that as it may—that in 2018, only 74 per cent of practices were open in what are called the core hours, between 8 a.m. and 6 p.m., and during those core hours they don't even have to be seeing patients. So, almost 30 per cent of them are not meeting that target, and that target isn't very effective anyway. I could go on, and I'm sure many of you across the Chamber could contribute as well.
So, why are we in this situation? Now, I'm sure the Minister, in his contribution, will talk about the Tory Westminster Government and austerity, and of course there's an element of truth in that. We don't have a magic money tree, as somebody once said. You can't produce resources from nowhere. But let me remind him, Deputy Presiding Officer, that his party has been in charge of the health service in Wales for 20 years, and for the first 10 of those years, from 1999 to 2010, times were relatively healthy in terms of public budgets.
I'd like to draw the Chamber's attention to some manifesto commitments from the Labour Party in the 2003 election. They began with a fairly open and honest contribution about what they hadn't done.
'We have not met...our targets to reduce waiting, but the solution in these areas is not to change direction or scale back on investment, reform and capacity building—it is to go faster and further'.
Well, fair enough. So, they then went on to say:
'In our second term we will ensure no-one waits more than 24 hours to see a member of their Primary Care Team, while at the same time widening the range of services provided at a local level.'
That would have been an excellent plan. They also went on to say:
'In our second term we will recruit 3,010 extra nurses and 410 extra doctors.'
Now, I must remind the Chamber that this was at a time when resources were not tight, and it didn't happen.
So, let's roll forward to the present day, and evidence from Health Improvement Wales and Social Care Wales that will be placed before the health committee tomorrow. It's written evidence, so it's already in the public domain. The evidence states
'The overriding aim of the strategy will be to ensure that, by 2030:
'We will have the right workforce to be able to deliver flexible and agile health and social care that meets the needs of the people of Wales.
'We will have a workforce that is reflective of the population’s diversity,'
and that
'We will have a workforce that feels valued.'
By 2030. Thirty-one years after the Minister's party took control of the health and care services in Wales.
I don't pretend that I know all the answers—I don't suppose anybody knows all the answers—but we do know that there are other big institutions, for example, multinational companies, with complex needs, varying markets, varying levels of demand, that plan their workforce to meet needs and they succeed in doing that years in advance. We might not want to follow their example, of course—there may be some ruthless practices that we wouldn't want to go within 100 miles of—but it does prove that it is possible to effectively plan the workforce that you need in a complex situation. We know we need competent management, we know we need proper resources, and we know we need people who are experts in workforce planning.
Now, the Minister will say that we have all this, but I would submit to this Chamber that that simply cannot be the case. Because, otherwise, we would have effective services in the places they were needed when people needed them. We know how important it is—and the Minister has said this frequently himself—that we strengthen our services in the community, because that is not only better for patients, but it also keeps patients out of secondary care, which is so much more expensive. Nobody wants to be in hospital—good primary care can make sure that that's not where people end up.
So, something is really wrong. And I'm sure that we will get the usual complacent response from the Minister saying that everything will be fine. Well, perhaps I'm a sceptic, Deputy Presiding Officer, but after 20 years, I'm beginning to doubt it. I think that the best chance of us sorting this out is a change of Government. Meantime, the Minister must show leadership and give direction and challenge. And above all, he must not be complacent about those communities that Huw Irranca-Davies has highlighted, which are not receiving the community services they deserve. We have waited as a nation long enough for the community health services that we need, and Labour in Wales has run out of excuses.

I have selected the five amendments to the motion. If amendment 1 is agreed, amendments 2, 3 and 4 will be deselected. Can I ask the Minister for Health and Social Services to move formally amendment 1 tabled in the name of Rebecca Evans.

Amendment 1—Rebecca Evans
Delete all and replace with:
To propose that the National Assembly for Wales:
1. Notes the positive action underway through the Primary Care Model for Wales to improve people’s access, day and night, to the right professional and service for their particular needs.
2. Notes the marked improvement in the recruitment of doctors to the GP speciality training programme this year.

Amendment 1moved.

Vaughan Gething AC: Formally.

Thank you. I call on Caroline Jones to move amendment 2, tabled in her own name. Caroline.

Amendment 2—Caroline Jones
Add as new point after point 1 and renumber accordingly:
Regrets that over 119,000 patients in Wales are covered by GP practices at risk and calls upon the Welsh Government to ensure that primary care is adequately funded by receiving at least 10 per cent of the overall NHS budget.

Amendment 2moved.

Caroline Jones AC: Formally. Diolch, Dirprwy Lywydd. I thank Plaid Cymru for tabling this debate today. For those who didn't attend the BMA's briefing on the current state of general practice in Wales, let's just say that the message was dire.
As alluded to in my amendment to this motion, nearly 120,000 GP patients are covered by practices at risk. The BMA produced a heat map covering all health boards, highlighting practices that have closed and those under threat of closure. Aneurin Bevan has 32 practices with an uncertain future.
GPs at the event expressed concern that general practice might never recover from the damage being done by underinvestment and mismanagement by local health boards. Practices are simply handing back their contracts because they cannot cope. GPs are being asked to do much more with a lot less. We are spending more than ever on healthcare, yet the share given to primary care has continued to shrink. Despite 90 per cent of all contacts with the NHS occurring in primary care, primary care receives around 7 per cent of NHS funding. On top of this, practices are being stung by enormous service charges and directives that do allow for strategic planning or expansion of premises.
We have to do all that we can to protect general practice in Wales, and we have to start by ensuring fair funding for GPs. Primary care should receive at least 10 per cent of the NHS budget. The share of the budget has been falling year on year, and anything under 10 per cent is simply unsustainable. We also have to address the enormous service charges imposed on GP practices by health boards.
The independent contractor model for primary care has served Welsh patients well for decades, but it is now facing an existential threat. If we lose these GP practices, then we lose primary care for good. Health boards have proved they cannot manage practices as well as our independent GPs. Local health board-managed practices cost as much as 30 per cent more to run.
General practice is the front line of our health service, and it's time that the Welsh Government recognised this and did all it can to adequately fund and provision it. Diolch yn fawr.

Thank you. I call on Angela Burns to move amendments 3, 4 and 5, tabled in the name of Darren Millar.

Amendment 3—Darren Millar
Add as new point after point 1 and renumber accordingly:
Notes the ongoing concerns of the British Medical Association Cymru regarding the future sustainability of primary care services and the publication of the latest Welsh GP practice heat Map.

Amendment 4—Darren Millar
In point 2, after 'staff' insert 'and other health professionals'.

Amendment 5—Darren Millar
Add as new point at end of motion:
Further calls on the Welsh Government to undertake a root and branch review of workforce planning within the Welsh NHS.

Amendments 3, 4 and 5 moved.

Angela Burns AC: Thank you very much, Deputy Presiding Officer. I formally so move those amendments. I'd like to thank Helen Mary Jones for opening this debate, and I think the word or numbers '2030' will forever be emblazoned on my heart after today's series of debates, what with hepatitis C and the diagnosis targets, because you mention about the fact that we need our workforce in place, and the concern we have is the fact that the workforce is so out of kilter with the ever-growing needs of the population. Our cancer survival rates still lag behind other countries, and it's a recognised fact that early diagnosis is key to ensure that patients have a better chance of survival.
Now, Welsh Government have brought forward fresh thinking with the single cancer pathway and the rapid diagnostic clinics, but, according to Cancer Research UK, this work is at risk of being undermined by gaps in the workforce. Patient demand is increasing, the number of confirmed cases of cancer will increase to an annual total of 25,000 a year by 2035, up from the current 19,000. So, we must ensure that our diagnostic workforce keeps pace with that.
Again, for example, the demand for imaging services has risen by 10 per cent per year over the last five years, and yet the radiology workforce has only risen by 1 per cent. I see it in my health board of Hywel Dda, and I'm sure that other Members see it in the health boards that they have to deal with on a day-to-day basis. Most worryingly, all bar one health board are struggling to recruit and retain radiographers, and this last year, Welsh radiology departments spent an estimated £8.8 million on outsourcing, overtime, and insourcing extra staff—up by almost £4 million. If we had that £8.8 million that we could actually spend on training—because you need the training places and then recruiting the radiologist to our health boards—we would have a better use of that funding. Yes, Huw.

Huw Irranca-Davies AC: Thank you for giving way. I'm always interested in these debates to hear ideas of how we can resolve some of these quite complex situations. A number of members of my family are involved in radiography—some as clinical tutors within radiography as well—and we are training a lot of people, and yet, we still have parts of Wales, including places like Powys and Ceredigion and so on, where those trainees are choosing not to go and work where there are vacancies in those hospitals to work. So, we're training the people but they're choosing to go to Cardiff or to Bridgend or to wherever. So, I'm interested in the practical ideas about how we can resolve this, because we're doing the training in a number of these specialisms, but we're unable to recruit them into the areas that we need them.

Angela Burns AC: And, of course, one of the ways of doing that is how we place our medical training places, where we put them and what we tie people into, because it's a recognised fact that if you start to train in a particular area, and you develop your social life there, your network there, you're far more likely to stay. I'm really sorry, I didn't realise I only had three minutes on this.

I shall be generous because you've taken an intervention, but it is three minutes normally.

Angela Burns AC: Thank you. There are similar shortages, obviously, with endoscopy nurses.
I did want to just touch on Caroline Jones's amendment, because we will be abstaining on it. Not because we don't support it, because we absolutely do, but the fundamental issue that we have with access to primary care services is that everything that this Government has done—the parliamentary review, the vision for health—is predicated on us taking our potential patients and seeing them at home, in the community, before they go anywhere else and do anything else. And primary care, I suspect from the numbers that I'm running, needs substantially more than 10 per cent in order to be able to meet the ambitions that we've all cleaved to as parties across this place on the parliamentary review to try to move that emphasis away from hospitals and into—[Inaudible.] So, it's a good amendment, but we can't support it because you put a number to it.

Perhaps this might just be the time to gently remind Members that in a half-hour debate, Members get three minutes to move amendments, three minutes to speak. The Government response gets six minutes, and the mover and the closer get a total of eight minutes between them. In moving and seconding I will be generous, but for the next debate, I will not be generous, because you've now been told. So, there we go. Siân Gwenllian.

Siân Gwenllian AC: Thank you very much. It’s encouraging news that 186 training places for GPs have been filled this year, which is an increase on the 136 available in 2017, which happens to be the same figure exactly as the one in 2010. It’s vital that this momentum is maintained and accelerated, as we heard from Helen Mary, in order to develop the vital workforce for the future, so that we can provide better access to services to patients. It’s important that this increase happens in different parts of Wales, and we need to plan in detail, with 23 per cent of GPs likely to retire in five years' time.
Members will be aware of the difficulties arising in my constituency, as GPs retire and a surgeries fail to attract new GPs, particularly those who can provide services through the medium of Welsh.
And some of you will also remember that I have been arguing the case for having a medical school in north Wales, at Bangor University. And after a great deal of persuasion and discussion here, the Government yielded, and by now, the first cohort of medical students are studying medicine in Bangor and the work continues there.
The Minister was loath to introduce this at the beginning, but he did see that the argument that we put forth was a very sound one, namely that there is evidence from all part of the world that shows that medical students remain close to the place where they are trained. And I am of the belief that some of this first cohort in Bangor today will start to plug some of the gaps in our surgeries and our hospitals, thus improving patient care across north Wales. But we need more training places, including those in Bangor, and I'm sure that a full medical school will come to Bangor soon.

Rhun ap Iorwerth AC: Thank you very much. It is wonderful to see the medical school there, or the medical education there developing, at least. Would you agree with me that what I currently see in my constituency, in the Holyhead area—where there are two surgeries that, because of failures to recruit GPs, have had to transfer to the management of the health board, and that causes a crisis in terms of primary care in Holyhead—is proof yet again of the need for us to move towards training far more doctors, which won't help us today, but will certainly make things easier in future years?

Siân Gwenllian AC: Certainly, yes. This long-term planning is vital to avoid situations such as that in the future. And that’s why I’m so pleased—if truth be told, I went to visit the 18 students in Bangor being trained at the moment,and it’s wonderful to see that, but we need that to increase and to accelerate as well.
There's a lack of dentists as well, which is creating problems in terms of access to dentistry services in the same way. And in my constituency, this means that people have to travel very far to receive treatment on the NHS. And certainly, we need more dentists in that area. And the way that the dental contract caps the numbers of NHS patients is also decreasing access to dentist services.
I see that time is against me. It’s vital that patients in Wales, who need to see a GP or a dentist, can have equal access across Wales to these services—equal in terms of geography, and equal in terms of income and also in terms of age.

Jenny Rathbone AC: I agree with those who have already said that primary care needs to get more resources, because we have to remember that 97 per cent of people never go anywhere near a hospital. So, I wouldn't disagree with what Angela Burns said, that we probably need to have it as more than 10 per cent, but it's good to see the Brexit Party supporting a 10 per cent target. It will be interesting to hear what the Minister has got to say on that.
Primary care is the last open access service. Often, primary care is dealing with issues such as debt or domestic violence, which of course have a serious detrimental impact on people's health, but aren't issues that necessarily couldn't be dealt with by other agencies. So, we have to get better at ensuring that we've got that multidisciplinary support for people who are turning up in primary care who could be seen by a debt counsellor or could be seen by a social worker, who can help them dig themselves out of very difficult situations.
I think one of the frustrations for my constituents is the inconsistency of access to primary care. So, we have some GP surgeries where you're able to book an appointment online, and others where you can't. I think it's quite difficult for patients to understand why that is. I note the uptake of a digital booking system has gone up from about 220,000 to 350,000, but that's well short of the target of over 870,000, and it would be interesting to hear from the Minister as to whether doctors' surgeries are simply refusing to engage with the way in which the world has moved on, technically. People expect that, if they can buy a book online, a ticket to a match, or a piece of clothing, they feel they ought to be able to book a doctor's appointment online, rather than having the frustration of holding onto the phone at 8 o'clock in the morning in the hope that they will get answered before all the places have been booked.
I raised in the Assembly a couple of weeks ago the fact that people who need to get their ears syringed were instead being told by GP surgeries that this was no longer in the general medical services contract and they were being diverted to other agencies who were charging up to £95. So that needs sorting out, because these are pretty basic pieces of primary care intervention, just the same as foot care for older people, who can become crippled if they don't have somebody to cut their toenails, if they can no longer reach down and cut them themselves.
So I think these are really important things. I acknowledge completely that we've boosted Choose Pharmacyto enable simple primary care tasks to be done on a walk-in basis by the pharmacist, who is a highly trained individual and much underused. But I think that we have to acknowledge that there's much that's going on that's very good.
There are some existential threats to the health service arising out of Brexit. The first one is just that we've got over 1,300 NHS workers from Europe employed by the NHS in Wales, including 7 per cent of our doctors. Are we going to be able to retain them if Brexit goes ahead? People might feel they're no longer welcome here and they're certainly able to vote with their feet. These are highly employable anywhere in the world.

Are you winding up, please?

Jenny Rathbone AC: I think that the biggest thing, I'd like to say, the biggest existential threat, is over potential US trade talks, which could lead to a massive increase in drug prices, if Donald Trump has anything to do with it, and particularly a lack of access to generic drugs, which are really, really important in keeping the budget for drugs down. And there are some pretty terrifying things going on in terms of identifying that this could actually nearly triple in price. So that's something that it's difficult for us to guard against, as drug purchases are not a devolved matter.

Thank you. Can I now call the Minister for Health and Social Services to reply—no, not to reply to the debate, to add to the debate? Vaughan Gething.

Vaughan Gething AC: Thank you, Deputy Presiding Officer. I'd like to thank Members who've contributed to this debate. Of course, access to primary care services is a key part of the Government strategy 'Prosperity for All'. Medical services are a vital part of primary care for people across Wales and valued by us all. It's a real positive that, in the latest national survey, 93 per cent of people were positive about their most recent experience in primary care. However, we're all aware of the challenges that Wales and every country within the UK faces.
The old way of delivering primary medical and dental services is not sustainable, so we need to move on and rise to the challenge, as Members have recognised.'A Healthier Wales' sets out our joint vision, across health and social care, for a whole-system transformation. Our vision is that everyone has a longer, healthier and happier life, is better able to remain active and independent in their own homes as long as possible. To do that, to deliver that transformation, we recognise the need to develop and diversify our workforce, to change the way that we work and signpost people to the most appropriate local service, to deliver the right care, at the right time and in the right place.
So, our health boards do have an ambitious work programme, with a focus on delivering a 24/7 model for primary care, that's both in hours and out of hours, with the roll-out of our 111 service. And, of course, to help move forward on the transformation of primary care, I've already invested £89 million in the transformation fund. Every single health board area in Wales is trialling a new and a better way of working.There are, of course, always going to be specific challenges that need to be addressed within local communities. I recognise the comments made by Huw Irranca.

Huw Irranca-Davies AC: Will you give way, Minister?

Vaughan Gething AC: I can.

Huw Irranca-Davies AC: I thank the Minister for giving way, and the reason I ask him to give way is to ask him to join with me in welcoming something that he stood here in the debate with me previously, which is the issue of primary care provision in Llanharan. I hope he'll join with me in applauding Pencoed Medical Centre who have actually made the decision now, working with the local health board, finding some money available, to extend back into Llanharan and Brynna to provide 4.5 days a week of outreach surgeries into those communities, and he knows the impact it had on those communities. So, there are ways through this with the will and with a bit of clever funding put in the right direction.

Vaughan Gething AC: And that's a good example of the sort of progress we need to make to deliver real access to primary care. And I remember meeting the Member together with his local constituent to discuss the issues. I do get to go out and about and to hear directly from staff and residents. For example, I recently returned to Bryntirion with Hefin David to meet the team in a managed practice to hear about their challenge that happened when GP partners retired. They now have an occupational therapist, a clinical pharmacist, a physiotherapist, health support workers and access to paramedics as part of that team, and they're now planning for the future and much more optimistic. The primary school in Ely I visited to see the Designed to Smile initiative, a significantly effective programme shown to have achieved a 13.4 per cent reduction in the levels of dental decay in five-year-olds since 2008. And, of course, in Taff's Well, that practice is able to operate a GP triage system, and routine appointments are being delivered in one to two days. And that's now across the cluster; they're using funding to help provide patient information and signpost to wider services. There are the points that other people have made about investing in wider primary care services, in Choose Pharmacy and optometry, for example.
It was at Taff's Well, of course, that I announced the access standards for general medical services. I set out clearly what I and the people of Wales expect in providing real access. It's backed by £15 million of investment in the GP contract for access, including new digital telephony to help make it easier for patients to contact practices and access the services they need.
I will take one more intervention then I will need to make more progress—

Angela Burns AC: I'm just really grateful, and I'm glad to hear all that good news; it is supremely positive. But I do want to point out that we have 29 practices at risk which have submitted sustainability applications, and another 29 at risk which are in the pre-application process. So, how does all that good news tie to the fact that we've got practices that are on the verge of closure or are under real problems of sustainability?

Vaughan Gething AC: As I've said many times in this Chamber, we will need to change the way that we deliver primary care. Single and double-handed practices, their ability to deliver the sort of range of services that we need, that's part of the reason we introduced clusters to help GP practices to work together with the wider primary care team to deliver a more sustainable way of delivering care.
Primary care will change and it should do to meet the legitimate expectations of the public and, actually, the agenda for health and care provided in the parliamentary review and in 'A Healthier Wales', and it includes dentistry, of course. More than 40,000 NHS patients regularly receive NHS dental care compared to five years ago. We're witnessing the highest ever level of child access to general dental practice, and that does not yet include children accessing the community dental services. We've also seen a reduction in children having general anaesthetics. Our reform agenda should help further to improve access, as we've previously discussed in this Chamber.
But it's not all, of course, about money or systems—it's about people and making sure we have the workforce to meet our needs. So, I'm delighted that this year we have once again overfilled our GP training places against an increased target. I increased the quota for GP training places from 136 to 160, but we have 186 places filled, the highest number of recruits into GP training ever in the history of Wales, and every single GP training scheme in every part of the country has been filled. That's part of our 'Train. Work. Live.' initiative.
While GP training incentives have helped us to meet our recruitment targets, it is an area where some of that recruitment has been historically difficult. There are, of course, challenges, and there will always be specific local issues to address. However, we do know what those challenges are. We have a vision for what we want to do, and we have a plan to achieve it. And more than that, we're taking action. We should be proud of the progress that we are making and delivering. 
For my part, I recognise that there is always more to do and I am far from complacent about the challenges that face us, but this is a Government that is determined to keep our promises to meet the challenges that we face, in improving access to primary care, and I look forward to having more good news to report to the Chamber exactly on that in the next 18 months.

Thank you. Can I call on Helen Mary Jones to reply to the debate?

Helen Mary Jones AC: I'm grateful to the Deputy Presiding Officer and to all Members who have contributed to this debate. I have very little time. The Deputy Presiding Officer has been kind enough to say she'll be generous, but I know better than to push my luck.
I'm grateful to Angela Burns for her support and we will be supporting her amendments 3, 4 and 5. She rightly highlights the increased demand, but that increased demand is not entirely unpredictable. We need to be able to look at the likely demand and to plan, and we're not doing that effectively yet.
Caroline Jones was right to highlight what the BMA have told us. I don't share her view that directly managed practices can't be successful. They're often more expensive because they're serving poorer areas with higher levels of need, but she's absolutely right to say that the current model isn't sustainable and that action is urgently needed. We won't be supporting her amendment 2, more or less for the same reasons as Angela Burns gave, because 10 per cent may or may not be the right figure. It may not be enough. It may be that we need more. It may be that at some point we can spend less. But I fully accept that the amendment is offered in the right spirit.
Siân Gwenllian rightly highlights particular concerns in her own area and talks about equal access, equal access not only geographically, but as we heard in my exchanges with Huw Irranca-Davies, around the need for the right services for people who find it more difficult, for poorer communities. It's very interesting she mentions the final arrival of the clinical school in the north, which was, of course, another thing that was promised in Labour's 2003 manifesto. I don't think we would have it by now if it hadn't been for the pressure from Siân and her colleagues, and we're still waiting for the clinical school in Gwent—a challenge we might offer to those Members who represent that area.
Jenny Rathbone is absolutely right to talk about the issues of inconsistency of access and I share some of the concerns she raises about Brexit. Also, some of the comments she made were similar to those of Huw Irranca-Davies, and, in that context, I look forward to them supporting the motion and rejecting the amendment because the amendment is, I'm afraid, the usual self-congratulatory nonsense from the Government. Why will they not just oppose our motions if they don't agree with them? The Minister says things like he is not complacent, and then he speaks as if he is. He talks about there being specific challenges and that we will recognise them and meet them. Well, Deputy Presiding Officer, we've been waiting 20 years for his party to meet them and his manifesto of 2003 identifies those challenges, sets out things that should have been done to sort them out, and he cannot wash his hands and pretend that it isn't a matter for him. His party has had this time. He says he's not complacent; well, that isn't how it feels from where we're standing, and I notice that there are some of his colleagues on his own backbenches who may not be very happy either.
In the end, this is not about problems in one or two places. This is not about problems of access in certain communities. It is something that all of us across this Chamber—and Labour Members have mentioned it today—recognise is affecting their constituencies. Twenty years on, it isn't good enough. He should either get on with it or get out of the way.

The proposal is to agree the motion without amendment. Does any Member object? [Objection.] Object. Therefore, we defer voting under this item until voting time.

Voting deferred until voting time.

11. Plaid Cymru Debate: Betsi Cadwaladr University Health Board's New Rotas

The following amendments have been selected: amendment 1 in the name of Rebecca Evans, amendments 2, 3 and 4 in the name of Darren Millar, and amendment 5 in the name of Caroline Jones. If amendment 1 is agreed amendments 2, 3 and 4 will be deselected.

We now move to item 11, and can I just remind Members again of the timings? I have been generous in the last half-hour debate. I will not be as generous in this half-hour debate because you have all been told what the timings are. So, item 11 is a Plaid Cymru debate and it's on Betsi Cadwaladr University Health Board's new rotas, and I call on Llyr Gruffydd to move the motion. Llyr.

Motion NDM7179 Rhun ap Iorwerth
To propose that the National Assembly for Wales:
1. Opposes Betsi Cadwaladr University Health Board’s decision to introduce new rotas that will extend shifts for nursing staff from January 2020.
2. Believes this is a damaging and retrograde step—particularly at a time when more than one in ten nursing posts in the health board is vacant.
3. Notes that BCUHB has been in special measures for the past four years and is therefore under the direct control of the Minister for Health and Social Services.
4. Calls on the Welsh Government to overturn the decision and protect nurses’ working conditions.

Motion moved.

Llyr Gruffydd AC: Thank you, Dirprwy Lywydd. Now, last week, of course, Betsi Cadwaladr University Health Board decided that they would force nurses, midwives and healthcare support workers to extend their shifts for no extra pay. The plan was to enforce an extra 30-minute unpaid break per shift, even though many nurses, of course, don't have time to take their breaks as it is. And by the health board's own admission, it would have meant nurses working an extra unpaid shift per month to make up their hours. Now, the decision was meant to save around about £25,000 a month. Not an inconsiderable sum, you might say, but, of course, when you put it in context, the board is already spending over £1 million a month on agency nurses, then it's a relatively tiny amount of financial saving, but the health board was willing to destroy the goodwill of nursing staff that keep our NHS working.
I, as I'm sure many of you have, have received hundreds of messages in the last few weeks from the nurses, the patients and their families who would potentially have been affected by this. Those people working on the front line were saying—I'll quote one nurse—
'This will be the final nail in the coffin for nurses working for Betsi. We already work on understaffed wards, so we're lucky if we take a break, and this will mean lots of nurses moving away from the nursing profession and I will be one of them.'
Another nurse told me:
'This decrease in pay would involve me working an extra 6-hour shift a month, causing significant childcare issues and increased costs for this. I feel the people responsible want more and more out of an already-struggling workforce'.
And, of course, don't forget that over 1,000 nurses in Betsi Cadwaladr health board are aged 55 and over, and if you lose that group of experienced and dedicated professionals because of this misguided attempt—I have to say—to save a few pounds, then you will clearly reap what you sow. One in 10 nursing posts at Betsi are currently vacant, meaning that overstretched nurses and staff are already having to work extra hours anyway.
Now, this proposal has wrecked morale in a workforce already on the brink, and many nurses, as I quoted, have said that they will quit, some saying that they would retire early, others suggesting that they might even have to take sick leave if the scheme was introduced. Plaid Cymru and the unions have fought this tooth and nail. We collected, as a party, over 3,500 names on a petition. Unite as well collected the petition; collectively, I think it's over 8,000 names between us. And the union, of course, were even talking of balloting members on possible industrial action, even strike action. Now, what does that say when dedicated health professionals are saying 'enough is enough' and would consider the unthinkable and take strike action to safeguard their working conditions? And that, of course, was the context in which we, Plaid Cymru, brought this motion before the National Assembly today. A situation that nurses, midwives, healthcare support workers, patients and so many others of us find intolerable.
But, of course, things have changed. Late this afternoon, news broke that Betsi Cadwaladr University Health Board have shelved the proposals in a clear victory to those of us who have been campaigning for this, and, of course, a huge relief to those who would have been so affected by these proposals. But there are so many questions, now, to be asked. How did it come to this? Why did the board not see the folly of its ways sooner? Plaid Cymru brought a debate on this very issue to this National Assembly a few weeks ago; the Minister could have stopped it then, but he chose to back the board. There are big questions about this whole process and how meaningful, really, was the consultation process. So, I look forward to hearing what the Minister has to say about this whole debacle and how a health board under his direct control was allowed to pursue these proposals in the first place. And I will be looking, Minister, in your response, for a guarantee that this will not be allowed to happen again. If you give us that, then I probably won't move this motion to a vote this afternoon, but, if you don't, then, clearly, we will need a statement from this National Assembly making it clear that this proposal was wholly unacceptable and that we will not tolerate such a proposal again in the future.

Diolch. I have selected five amendments to the motion. If amendment 1 is agreed, amendments 2, 3 and 4 will be deselected. I call on the Minister for Health and Social Services to formally move amendment 1, tabled in the name of Rebecca Evans.

Amendment 1—Rebecca Evans
Delete all and replace with:
To propose that the National Assembly for Wales:
1. Values the NHS workforce and our social partnership working arrangements in Betsi Cadwaladr University Health Board (BCUHB), and in all health boards across Wales.
2. Notes that BCUHB continues to engage with nursing staff and their trades unions on changes to nursing rotas.

Amendment 1 moved.

Vaughan Gething AC: Formally.

Thank you. I call on Mark Isherwood to move amendments 2, 3 and 4, tabled in the name of Darren Millar. Mark.

Amendment 2—Darren Millar
Insert as new point after point 2 and renumber accordingly:
Further regrets that the number of working days lost due to stress and mental health related issues within the health board has increased by 20 per cent since 2014.

Amendment 3—Darren Millar
In point 3, delete 'the past' and replace with 'more than'.

Amendment 4—Darren Millar
Insert as new point after point 3 and renumber accordingly:
Regrets that the Minister for Health and Social Services has failed to prevent this decision from being made.

Amendments 2, 3 and 4 moved.

Mark Isherwood AC: Yes. Well, we regret that the Minister for Health and Social Services has failed until now to prevent this decision from being made. We further regret that the number of working days lost due to stress and mental health-related issues in Betsi Cadwaladr University Health Board has increased by 20 per cent since 2014. And we note that the health board has been in special measures for more than four years and is therefore under the direct control of the Minister. I move amendments 2, 3 and 4 accordingly.
Effective management understands that stress and burnout are primary causes of high staff absenteeism, as are the low morale and lack of motivation that occur when staff feel undervalued and under-appreciated. Yesterday, the health board's chief executive wrote to members regarding the changes to shifts for nurses and healthcare support workers, stating:
'Staff should not be paid for breaks other than in those circumstances set out.'
He added that the health board had consulted its staff and trade union partners over the proposed changes. However, the Unite union's regional co-ordinating officer stated yesterday that staff are angry and are willing to take industrial action, whichhe had never heard nurses say before.
Many nurses have written to me and the following quotes are theirs:
'If Betsi proceeds with their current plans they risk alienating further the staff they depend on. Also recruitment to fill vacant posts with are already difficult to fill and will be negatively affected.'
'I do not know how someone working fulltime with a family will be able to manage. I am seriously considering leaving my profession and I know of many others thinking of doing the same, which will not help the national shortage problem.'
'The change is reactive and has small chance of helping to redress the agency budget, and will have a knock on effect...on staff engagement...that will lead to greater difficulties in the long term'.
'In a 12 and a half hour shift...breaks are vital but due to the workload we wouldn't always take our breaks or they would be disturbed or shorter than needed. Making the breaks unpaid will not change this'.
'I am almost always the only Band 7 midwife on a night shift. This means that I am never able to take my break. I never claim time back...if this proposed change comes into force, I will be claiming every second extra that I work and I am sure that all of my colleagues will too'.
When I wrote to this health Minister with these concerns, he replied that neither he nor his officials can intervene in operational matters. Well, if special measures is to mean anything, the Welsh Government must take responsibility and act. Or has it now blinked? Because the local press announced just two hours ago that the health board has now, belatedly, u-turned.

Thank you. I call on Mandy Jones to move amendment 5, tabled in the name of Caroline Jones.

Amendment 5—Caroline Jones
Add as new point at end of motion:
Further calls on the Welsh Government to ensure that Betsi Cadwaladr University Health Board and other health boards across Wales do not attempt to circumvent the Nurse Staffing Levels (Wales) Act 2016 by reclassifying working patterns.

Amendment 5moved.

Mandy Jones AC: Moved. Okay, a quick change of speech in a minute.
My group will be voting for this motion today, and the Brexit Party has also tabled an amendment in the name of Caroline Jones that calls on the Welsh Government to ensure that Betsi Cadwaladr University Health Board and other health boards across Wales do not attempt to circumvent the Nurse Staffing Levels (Wales) Act 2016 by reclassifying working patterns.
Minister, I've had a number of constituents contact my office over your controversial changes to rotas. My office has had nurses in tears, saying that they can't afford to do the extra shifts, the extra journeys to work. It's the childcare costs; it's even down to laundry. I find it outrageous that these changes were supposed to be made when an NHS manager in north Wales is being paid at a rate of almost £2,000 per day and allowed to work from home in Marbella. In this day and age, nurses shouldn't be in a situation like that. It's a profession we should all be proud of.
I will be looking forward to what the Minister has to say now that the health board have actually turned around this in the last couple of hours this afternoon, and, hopefully, squashed this debacle. But it is now clear that the biggest danger to workers' rights is not Brexit, but this Labour Government, who have failed to prevent this decision from being made in the first place.

Siân Gwenllian AC: Betsi Cadwaladr University Health Board's intention to introduce these new rotas had caused huge controversy locally, and that is entirely understandable. And I'm extremely pleased that there has been a change of heart now—we heard of it only around an hour ago. Had this gone ahead, it would have been exceptionally damaging and would have taken advantage of those nurses who do work so very hard and very often go way beyond the requirements of their posts. I am pleased that the decision has been overturned, but, from here on in, I urge the health board and the Government to give due respect to our nurses.
I received a letter this week from a nurse working in a hospital in north Wales, and, although the decision has been overturned, it's worth you hearing what she had to say: 'I've worked as a trained nurse for over 28 years, and I am appalled by the changes to the nurse rotas that are to be introduced after Christmas. I feel so strongly that I did have to write to you about the issue. Everyone is furious with the changes in the pipeline and I haven't spoken to any nurse who is in favour of this. Morale within nursing is very low already. No other body would accept such changes, which would mean the loss of goodwill, and certainly the goodwill of nurses is at the very heart of public services.' And, at the end of her letter, she asks what can we do to overturn this decision.Well, this nurse will be exceptionally pleased to hear that there has been a change as people raised their voices, as people came together to oppose and to campaign and support each other. And Plaid Cymru is proud to have worked with the unions in order to overturn this decision, which was absurd from the very outset.
I do urge the Government and the health board to learn lessons from this debacle—and it is a debacle. We must, from here on in, work along with the unions representing the staff at Betsi Cadwaladr University Health Board. Consultation must happen in a far more meaningful manner when changes are proposed. There is a great deal of bridge-mending work to be done now, and we must restore this relationship, and there's a huge amount of work to restore trust. And that's what worries me—that this whole chapter, which should have been avoided in the first instance, is damaging to the morale of nurses and to that relationship, and we must work very hard now in order to restore that situation. These nurses work so very hard for the benefit of their patients, and they must be fully respected from here on in.

Michelle Brown AC: Thank you to Plaid for bringing this motion. I'll be voting in favour of the motion, as I support our nurses, and I really don't think it's fair that their working conditions should worsen. The NHS has been built on the back of the nursing staff. Nursing is an incredibly pressurised, difficult job, and nurses need all the support that we can give them. And the proposals that came out of Betsi Cadwaladr relating to the rotas are, in my opinion, unbelievable. I'm glad that they've decided to shelve the proposals, but the thinking behind these proposals is worrying in itself. It would seem to be a counter-productive thing to do to change the working conditions of nurses to their detriment when the board is desperate to recruit nurses and other staff. And, despite Betsi shelving the proposals now, I'm sorry, I think the damage has already been done. Other Members have spoken about the reduction in, the worsening, morale, but it's going to make employment in Betsi Cadwaladr all the less attractive at a time when the board is in dire need of quality staff, and needs to make itself as attractive as possible to recruits.
We're all very familiar with the story of Betsi Cadwaladr and the numerous ways it has fallen short of what patients in north Wales are entitled to expect from their NHS. And, further, we're all aware of how the Welsh NHS under Labour has decayed and is increasingly failing the Welsh people. This erosion of the working conditions of nurses, or rather the now-shelved proposals, would not have been proposed were it not for Labour's failure to solve the problems at the health board over the years it has been in special measures, and under the direct management of this Labour Government. It could also be seen as a cynical attempt to get the public to blame the problems on the staff and the nurses by saying that they're having too many breaks. But it's not the fault of front-line staff, and I resent that every time a criticism of the Welsh NHS is made in this place, the Minister and Government run and hide behind hard-working NHS staff to deflect the criticism that's rightly placed at the Minister's door. No, it's the fault of the board and the Welsh Labour Government, who've mismanaged it. 
Yesterday, Jeremy Corbyn warned the UK electorate that choosing the wrong Government would see an erosion of workers' rights and long-term damage to the NHS. Well, I have a message to English voters: if you want to see how modern Labour runs a health service, come and look at Betsi Cadwaladr in north Wales. Since Wales is the only UK nation whose NHS has proposed to worsen nurses' employment terms and conditions, at a health board that is being directly managed by a Labour Government, in the only UK nation run by Labour, I can only assume that Corbyn was warning people against voting for a Labour Government in Westminster. I would agree with him there.
But I have to say I am surprised at the acute case of amnesia that Plaid seem to be suffering, having proposed this motion—and I do agree with the motion and I appreciate them bringing it—because they've clearly forgotten that they have in the past undemocratically propped up the Labour establishment that's mismanaged the NHS, even though their own voters voted against that same party. If Plaid voters had wanted to help a Labour Government stay afloat, they would have voted Labour. After supporting a Labour Government for years while the NHS decayed, Plaid has to take its share of the blame for the scenario NHS workers and patients are now facing. Plaid have never been an opposition party, and Wales is suffering as a result. But I will support the motion because I support the nurses. I won't be supporting Labour's invitation to pat themselves on the back and allow them to bury their heads in the sand, and I will be supporting the Conservative and Brexit Party amendments. Thank you.

Can I call on the Minister for Health and Social Services? Vaughan Gething.

Vaughan Gething AC: Thank you, Deputy Presiding Officer. I thank Members for their varied contributions. I want to make clear at the outset that we won't support the Conservative or Brexit Party amendments. As I noted during the debate on this issue on 18 September, staffing rotas are an operational matter, as they should be, and the responsibility of individual organisations—in this case, obviously, Betsi Cadwaladr university health board. Organisations need to consider rotas in light of their statutory duties to ensure that they're designed to meet service delivery requirements and the needs of staff, including in particular their well-being, and that they place patient need at the centre of the management of the workforce.
The motion before us states the health board is under my direct control. As we've said many times before, the Welsh Government is not, under special measures, directly running the health board. The board and leadership team remain responsible for operational matters. This is a point that's been well made many times before, and I believe is well understood regardless of the drafting of the motion.
During the debate in September, I set out my expectations that the health board would work closely with staff and trade unions on the proposed changes, consider and respond appropriately to all comments and concerns, and to consider any equality impact and all feedback before any final decision is made. I note that a draft equality impact assessment has been provided during the month of October.
Over the nine weeks of consultation—we extended it following a request from trade union partners—there were 53 separate meetings held across the three localities. The response to the consultation, the equality impact assessment and the health board implementation plan were published last week, following discussion with the local partnership forum.
I am of course, however, aware that there were ongoing concerns from trade unions on behalf of their members who work in north Wales, and that Unison, the RCN and Unite wrote jointly to the health board. I wrote to the chair of the health board last week, seeking assurance that they were continuing to engage with their staff and their trade union representatives to resolve outstanding concerns and to keep me updated on progress.
In opposing the motion today, the Government has moved amendments that reiterate the value that we place on our nursing staff and social partnership working arrangements here in Wales, and my continuing expectation that the health board will engage with staff and their representatives to resolve concerns.We have a track record in Wales of finding a way to reach agreement on a way forward. I know that there is a further partnership forum meeting that has been arranged for Friday this week. I expect all parties to continue to work in good faith to resolve outstanding concerns, and, whilst discussions are ongoing, the health board have made clear today in response to the joint trade union letter that they will not progress the proposed changes. They state that they welcome the joint communication with Unison, the RCN and Unite, that they are absolutely committed to working together with their trade union partners, they will focus on partnership working and how to move forward together, and that to do so they will not progress the proposed changes, and that the meeting for this Friday will be entirely dedicated to this matter.
I'm genuinely proud of our partnership approach here in Wales. We know that it does not exist in every other part of the United Kingdom. The Members who refer to other ways of working across the UK should look at what our trade unions recognise and say about the way we undertake business here in Wales. So, I look forward to this issue being resolved in partnership, in line with my expectations, but much more importantly in line with our established way of working here in Wales.

Thank you. Can I call on Llyr Gruffydd to reply to the debate?

Llyr Gruffydd AC: Well, I didn't in any way there hear any regret or remorse about the fact that we got to where we got to on this issue. An apology might have been nice, yes, or at least some acknowledgement that it shouldn't have come to this—a second debate in this Chamber asking for that principle to establish that these proposals should not go forward. The Minister tells us it's an operational matter, but if it's wrong, then you should say so. That's what Unite the Union are saying, that's what the RCN are saying, that's what Plaid Cymru has been saying, that's what the nurses and the patients have been saying. And you're saying you don't want to get involved. There we are, that's your decision, but I think people will read into that what they wish. And then, in responding to some of the comments, you say that we should ask trade unions about how we operate here in Wales. Well, my previous comment stands, I think—the unions are telling you what they think about this proposal and they absolutely do not want it to happen.

Llyr Gruffydd AC: We won’t be supporting the Labour amendment today because what it does essentially is to delete our motion in its entirety and present something that talks about the importance of engagement. That is important of course, but the very reason we’re bringing this motion forward today is to establish the principle that what is being proposed here is wrong in the first instance. We will be supporting all of the other amendments, by the way.
Siân Gwenllian was entirely right in saying that there are lessons to be learnt here. Although the decision has been overturned for the time being—and I say 'for the time being' because we may have to return to this if there’s an intention to reintroduce this—the damage has been done to a great extent in terms of undermining the workforce's confidence in the ability of the board to recognise and to listen to the voice of the workforce, and certainly from the point of view of the Minister to recognise that fact. It has certainly impacted morale, which was already low, and I’ve read some of the evidence, and others will have also read evidence, from those working on the front line, many of them on their knees because of the pressures and stress upon them, and yet the board expects more and more from them.
I have no doubt that this decision to withdraw this proposal in terms of nurse rotas in north Wales is a victory for Plaid Cymru, for the unions, for the nurses and the patients, too. I regret the fact that the Minister isn’t willing to accept that this was a mistake. We’ve been given no assurances at all that this will not be allowed to be reintroduced in future, and therefore, on that basis, I would ask Members that we move to a vote on this issue in order to establish the principle that we, as a National Assembly, do oppose the proposal put forward in order to ensure that there’s no possibility of that being considered again in the future.

Thank you.The proposal is to agree the motion without amendment. Does any Member object? [Objection.] Objection, therefore we proceed to a vote at voting time on this item. I am going to move to voting time unless three Members wish for the bell to be rung. No. Okay.

Voting deferred until voting time.

12. Voting Time

So, we're now into voting time. The first vote this afternoon is the vote on the Plaid Cymru debate on access to health services, and I call for a vote on the motion, tabled in the name of Rhun ap Iorwerth. If the proposal is not agreed, we vote on the amendments tabled to the motion. Open the vote. Close the vote. For the motion 13, no abstentions, 32 against. Therefore, the motion is not agreed.

NDM7178 - Plaid Cymru debate - Motion without amendment: For: 13, Against: 32, Abstain: 0
Motion has been rejectedClick to see vote results

We now move to vote on the amendments. If amendment 1 is agreed, amendments 2,3 and 4 will be deselected. So, I call for a vote on amendment 1, tabled in the name of Rebecca Evans. Open the vote. Close the vote. For the amendment 25, no abstentions, 21 against. Therefore, amendment 1 is agreed. Amendments 2,3 and 4 are deselected.

NDM7178 - Amendment 1: For: 25, Against: 21, Abstain: 0
Amendment has been agreedClick to see vote results

Amendments 2, 3 and 4 deselected.

I call for a vote on amendment 5, tabled in the name of Darren Millar. Open the vote. Close the vote. For the amendment 20, no abstentions, 26 against. Therefore, amendment 5 is not agreed.

NDM7178 - Amendment 5: For: 20, Against: 26, Abstain: 0
Amendment has been rejectedClick to see vote results

I call for a vote on the motion as amended.

Motion NDM7178 as amended:
To propose that the National Assembly for Wales:
1. Notes the positive action under way through the Primary Care Model for Wales to improve people’s access, day and night, to the right professional and service for their particular needs.
2. Notes the marked improvement in the recruitment of doctors to the GP speciality training programme this year.

Open the vote. Close the vote. For the amended motion 26, no abstentions, 20 against. Therefore, the amended motion is agreed.

NDM7178 - Motion as amended: For: 26, Against: 20, Abstain: 0
Motion as amended has been agreedClick to see vote results

We now move to vote on thePlaid Cymru debate on Betsi Cadwaladr University Health Board's new rotas, and I call for a vote on the motion, tabled in the name of Rhun ap Iorwerth. Again, if the proposal is not agreed, we will vote on the amendments tabled to the motion. Open the vote. Close the vote. For the motion 13, no abstentions, 33 against. Therefore, the motion is not agreed.

NDM7179 - Plaid Cymru debate - Motion without amendment: For: 13, Against: 33, Abstain: 0
Motion has been rejectedClick to see vote results

We move to vote on the amendments. Again, if amendment 1 is agreed, amendments 2, 3 and 4 will be deselected. So, I call for a vote on amendment 1, tabled in the name of Rebecca Evans. Open the vote. Close the vote. For the amendment 26, no abstentions, 20 against. Therefore, amendment 1 is agreed, and amendments 2, 3 and 4 are deselected.

NDM7179 - Amendment 1: For: 26, Against: 20, Abstain: 0
Amendment has been agreedClick to see vote results

Amendments 2, 3 and 4 deselected.

I now call for a vote on amendment 5, tabled in the name of Caroline Jones. Open the vote. Close the vote. For the amendment 20, no abstentions, 26 against. Therefore, amendment 5 is not agreed.

NDM7179 - Amendment 5: For: 20, Against: 26, Abstain: 0
Amendment has been rejectedClick to see vote results

And I now call for a vote on the motion as amended.

Motion NDM7179 as amended:
To propose that the National Assembly for Wales:
1. Values the NHS workforce and our social partnership working arrangements in Betsi Cadwaladr University Health Board (BCUHB), and in all health boards across Wales.
2. Notes that BCUHB continues to engage with nursing staff and their trades unions on changes to nursing rotas.

Open the vote. Close the vote. For the amended motion 26, six abstentions, 14 against. Therefore, the amended motion is agreed.

NDM7179 - Motion as amended: For: 26, Against: 14, Abstain: 6
Motion as amended has been agreedClick to see vote results

13. Short Debate: Remembrance and respect: Why we should protect war memorials in Wales

We now move to the short debate. If Members are leaving the Chamber, can they do so quickly, quietly? I now move to the short debate, and I call on Paul Davies to speak on the topic that he has chosen. Paul.

Paul Davies AC: Diolch, Dirprwy Lywydd. I'm delighted to use my short debate today to once again highlight the issue of the protection of war memorials across Wales. I'm deeply honoured to have the opportunity to once again raise the importance of protecting war memorials in Wales. As I've often said before, they are an essential part of the cultural and social fabric of Wales and Britain, and it's so important that these memorials are protected for years to come. Our future generations must remember and never forget those who died for our freedoms, and, by doing so, they can learn from previous conflicts so that they are never repeated again. It's therefore essential that governments at all levels do all that they can to safeguard these memorials, as sadly, in recent years, they have come under increasing threat.
Of course, this is not a party political campaign, as support for the protection of our war memorials has come from politicians at all levels and from all sides of the political spectrum, and I'm really heartened by the support shown by so many for this worthwhile cause. At Westminster, the then Member of Parliament for Liverpool Wavertree, Luciana Berger, said, and I quote,
'It is so important that we remember the enormous sacrifices made...to secure, for us all, the freedoms that we enjoy today. War memorials help us to remember the people who have given their lives. Memorials also help local communities and young people engage with local history.'
And at Holyrood, the Greenock and InverclydeMSP, Stuart McMillan, said, and I quote again,
'We owe it to our servicemen and servicewomen to preserve the monuments that honour and remember the fallen.'
Calls from politicians of all parties, and from all parts of the UK, remind us that we are not alone in seeking to honour our fallen heroes, and it also reminds us of the enormous impact that those conflicts have had on the United Kingdom. And so we have an opportunity to lead by example and work together to ensure that Wales's war memorials are safeguarded for the future.
Now, according to the latest estimates from the War Memorials Trust, there are approximately 10,000 war memorials in the United Kingdom. Each war memorial is unique in its own right. Some are plaques, others gardens, others statues, and others even windows. But each of them carry an enormous significance to the families of those who fell in previous conflicts and to the local community. For some, the names listed on a memorial may be the only record of that individual's sacrifice. That makes it all the more disturbing as we continue to hear stories of memorials vandalised and desecrated across the country. Members may remember, back in March, when a swastika was spray-painted across the Connah's Quay and Shotton war memorial. The vandalism of that memorial shows the deepest disrespect for the 70 soldiers who lost their lives during the first world war.
And that's not the only case of vandalism in recent months. The Boer War memorial on Swansea seafront, opposite St Helen's rugby ground, was daubed with anarchy symbols and the words 'smash empire' and 'troops out'. And following a climate change protest in north Wales in September, a war memorial in Bangor was vandalised. All of these events happened in the last 12 months, proving that the protection of Wales's war memorials is as important and relevant as ever. And so, today, in this Chamber, I hope Members will join me in saying that we will remember those who fought and died for this country, and that we, as representatives of communities across Wales, will do all that we can to protect and preserve their sacrifice.

Paul Davies AC: Now, as the Minister will be aware, this is not the first time I've called on the Welsh Government to protect war memorials in Wales. Back in 2012, I put forward many of the same arguments that I will today to the then Minister for Housing, Regeneration and Heritage, Huw Lewis. I have to say, the Minister's response was sincere, and at that time he committed to bringing forward proposals that would strengthen the protection of war memorials across the country. Sadly, whilst his sentiments were very much welcome, in reality, very little was done. And so I say, with the greatest of respect to the Deputy Minister, that I hope that the Welsh Government will start to take this matter very seriously. The then Minister said, and I quote:
'In terms of a statutory duty to protect, we now have an open process in the development of the heritage Bill in order to take a good, long look at that, although we must remember the complexity of the patterns of responsibility that Paul has already outlined.'
However, the subsequent Historic Environment (Wales) Act 2016 did not include any measure specifically to protect war memorials. Therefore, it remains a great source of regret that, in Wales, the only legislation specific to war memorials is the War Memorials (Local Authorities' Powers) Act 1923, and subsequent amendments. And so, above all else today, I sincerely hope the Deputy Minister will commit to reviewing the legislation around the protection of war memorials, and work with stakeholders to tighten up that legislation, and bring it into the twenty-first century. I'm sure the Deputy Minister will agree with me that this is the very least that our fallen heroes deserve.
Therefore, the first commitment that I ask of the Welsh Government today is to begin to undertake a nationwide, up-to-date inventory of war memorials in Wales. I appreciate that this is no small feat, but it's so important that data is recorded that details the number and locations of all war memorials here in Wales. This could be done via local authorities, who may be better placed to identify and draw up a list of the war memorials in their respective areas. Of course, I accept that, in some cases, memorials may be on private land, or, for example, located at a school or church, and, as such, the responsibility for maintaining those memorials would lie with them. And even today, I received correspondence regarding the vulnerability of unofficial war memorials, and the need for greater protection for them. Therefore, it's crucial that the Welsh Government works with local authorities to ascertain where our war memorials are located, and under whose stewardship.
Now, I accept that, as part of Cymru'n Cofio Wales Remembers 1914-1918, the centenary programme of commemoration of the first world war, Cadw launched the grants for war memorials in Wales scheme. As I understand it, it was developed in partnership with the War Memorials Trust, and aimed to provide funding for the repair and conservation of memorials across Wales, and that initiative is very, very much welcome. But funding is only one piece of the puzzle, and so it's vital that, moving forward, the Welsh Government works with organisations like Cadw and the War Memorials Trust, and also local stakeholders and authorities, to ensure that those memorials most in need of repair are identified, and, indeed, prioritised.
Therefore, I'd like to once again put it to the Welsh Government that there should be a statutory duty on local authorities to protect our war memorials. As I said back in 2012, this would mean that the legal duty would require local authorities across Wales to ensure that war memorials in their areas are maintained. We know that the war memorials Act 1923 permits local authorities to use public money for the maintenance of memorials, but councils are under no obligation to do so. This would involve ensuring that each local authority, working closely with community groups and organisations, have a specific custodian whose job it would be to identify and preserve war memorials in their areas. There's also an opportunity with the role to include some outreach educational work, to promote war memorials in local areas, for example, by visiting schools, and talking to children and young people. The creation of this role would send a clear statement that the Welsh Government is honouring its heroes by breathing new life. into their stories and ensuring that our future generations fully understand their significance in our history. It's a great shame that there are a number of local authorities across Wales where there is not a point of contact for the local community to find out more about memorials in their areas, and that is something that desperately needs to change.
It's only through collaboration between the Welsh Government, local authorities and local communities that we can ensure that war memorials are being protected properly. Therefore, it's my view that a statutory duty on local authorities to provide a conservation custodian or war memorials officer would be the best way to establish a point of contact for the public, develop partnerships with local community groups and organisations, which have already established responsibility for some memorials in the area, and, indeed, to forge links with local schools to educate children and young people about the importance of war memorials and to tell the stories of the great sacrifices made for us.
Of course, some community groups already do a fantastic job of protecting war memorials and they should be encouraged to continue to do so. Those groups must be allowed to continue their work and we must support the efforts of community groups, which have established responsibility for memorials in Wales. However, a strong, working relationship with a point of contact at a local authority would strengthen the level of protection offered to their war memorials and may be a way of better safeguarding them at a time when thefts and damage to memorials are actually on the rise.
And my final proposals, Dirprwy Lywydd, is to call on the Welsh Government to ensure that local authorities have the very best resources possible to combat those who are targeting war memorials for scrap metal. It's beyond comprehension why someone would choose to steal a memorial, or parts of it, but, sadly, this does happen. And we must remember that these are not victimless crimes at all—they are crimes against society and have far-reaching consequences for our communities. Therefore, I'm pleased that in 2013, the UK Government brought in the Scrap Metal Dealers Act 2013 to strengthen the regulations around scrap metal dealers and to tighten up the current regime.
The legislation now requires all individuals and businesses to complete an enhanced application process to obtain a scrap metal dealer licence, giving local authorities the power to reject unsuitable applicants and revoke licences. That legislation has had a huge impact, in fact, and it's estimated that metal theft had fallen by more than three-quarters in the first four years of the legislation coming into existence. However, there's always more that can be done. I'm sure that the Deputy Minister is already aware of the state-of-the-art SmartWater signature that is visible only under ultraviolet light, which will help police to trace stolen memorials. Once applied, SmartWater is virtually impossible to remove and can withstand burning, sandblasting and long-term exposure to UV. This is one way of protecting war memorials, and I hope that the Welsh Government would agree to developing a wider partnership with the SmartWater Foundation and the War Memorials Trust to use this powerful deterrent and ensure that our local authorities have access to it.
In closing, we have an opportunity to extend our scope of remembrance and show our armed forces community our utmost respect by pledging to protect war memorials in Wales. I for one am proud of Wales's military heritage and I believe that the Welsh Government should do everything within its power to work with others to help protect and promote our war memorials. This is about honouring our heroes and providing opportunities for our children and young people to learn more about them and the ultimate price they paid for our freedom. Therefore, I do call on the Welsh Government to genuinely commit to doing more to protect war memorials in Wales. We owe our fallen heroes nothing less.

Thank you. I'm going to call on the Deputy Minister for Culture, Sport and Tourism to reply to the debate—Dafydd Elis-Thomas.

Dafydd Elis-Thomas AC: Thank you very much for this opportunity to respond to the debate, and thank you to Paul Davies for choosing this very timely subject to discuss here.
The Assembly Commission, of course, is responsible for a notable memorial before this Senedd, and it's in that place that I'll be attending the merchant navy's service, because I continue to appreciate my post of being the honorary president of the merchant navy, as a recognition of the special relationship between us in this Senedd and our maritime heritage.

Dafydd Elis-Thomas AC: We have as many as 5,000 war memorials in Wales, and they take different forms—be they plaques or small cenotaphs. There are parks, there are hospitals and village halls that are also memorials and are part of what was invested by Welsh communities, with public support, to remember those lost from those communities in the first world war and the second world war, without forgetting, of course, the wars since then, or, indeed, the civil war in Spain.
Remembering these events is a duty on all of us. I have listened carefully to what was said by Paul today, and I have read what he has said before, and I praise his diligence in continuing to pursue this debate. Therefore, in responding, I want to say that we will look anew at our relationship with the War Memorials Trust. I do note that Historic England, the body that corresponds to Cadw in England, and, indeed, Historic Environment Scotland, have a direct relationship with the War Memorials Trust, and perhaps it would be appropriate for us too to strengthen our relationship with that trust, as we have collaborated with them in the grant scheme that Paul referred to.
Local communities, of course, do contribute, particularly in terms of the Royal British Region and volunteers to that vital work of looking after war memorials, and we do see the importance of us, as a Government, not just acknowledging that work but supporting these activities. It’s fair for me to say that Cadw has taken action in this field from the point of view of listing memorials. I accept that listing legislation does not mean that there is safety guaranteed for these memorials, but the number of memorials has increased, and the Welsh Government, through the Cymru’n Cofio Wales Remembers programme that Paul referred to, has been designating or noting the centenary of the first world war, and Cadw prepared practical guidance for communities wishing to conserve and care for their war memorials. And over 40 individual grants, totalling almost £230,000, have been awarded for conservation of all types of memorials, and that has now been allocated from that source. One of those is the other memorial that I will be visiting on Sunday, hopefully, namely the national war memorial in Cathays Park.
So, we as, a Government, have shown that we do have the will to care for memorials in Wales but we've also supported memorials of national importance outside of Wales, with expenditure of £25,000 towards the Welsh memorial in Flanders, and also support for the memorial in Mametz Wood, in northern France—expenditure of around £7,000 there. But as this specific period of remembering the first world war is coming to an end, and as we have collaborated with the War Memorials Trust in the past, I will commit that I am going to consider further how we can strengthen our action as a Government in the way that Paul has suggested. He wouldn't expect me to make a stronger commitment than that today, but I do have my own interest, not just from the point of view being the Minister with responsibility in responding today, but also as regards the importance of remembering and remembering appropriately. I appreciate very much the contributions that have been made in the different communities throughout the years to celebrate, to remember and to acknowledge, and to grieve of course. All of these aspects come together.

Joyce Watson AC: Will you take an intervention?

Dafydd Elis-Thomas AC: Yes, of course, Joyce.

Joyce Watson AC: Thank you very much. I know that this is an area that you feel very strongly about, so I just wonder whether you'll join with me in congratulating Patti Flynn, who saw, just last week, a plaque awarded to remember the members of the black and minority ethnic community who fought for us in the war. That plaque was put up at the Welsh National War Memorial in Cardiff last Saturday. I'm sure that we would all share in congratulating her—for 26 years she campaigned—but also at the same time in remembering those who gave their lives as well.

Dafydd Elis-Thomas AC: It was remiss of me not to mention Patti Flynn, a person for whom I have the highest personal regard. And, indeed, it's not only the importance of the commemoration of the war memorial to the black and ethnic communities that took such an active part in the defence of the United Kingdom and our communities at these difficult times, but it is also the importance for us, as a Government, in recognising that we are a genuinely multicultural society and multiracial society here in Wales. So, I'm very grateful to you for reminding me of the importance of Patti Flynn's contribution.

Dafydd Elis-Thomas AC: To conclude, I very much hope that this, today, is the beginning of this discussion. I look forward to working further with Paul Davies and other Assembly Members who clearly have interest and who have remained for today’s debate, to ensure that we do continue to commemorate and remember in an appropriate way those on whom our freedom depends.

Thank you very much. That brings today's proceedings to a close. Diolch yn fawr.

The meeting ended at 18:18.

QNR

Questions to the Deputy Minister for Economy and Transport

Joyce Watson: Will the Minister provide an update on the TrawsCymru service?

Lee Waters: Last year, TrawsCymru carried a record 2.5million passengers. We have made significant improvements to the network of services over the last five years, and the pioneering weekend free travel remains popular since being introduced in July 2017.

Lynne Neagle: Will the Minister provide an update on the effectiveness of the Learner Travel (Wales) Measure 2008?

Lee Waters: The current legislation that places duties on local authorities is generally working well. However, we are aware of increasing concerns for post-16 learners where local authorities have discretion over travel arrangements. We will take forward a review to identify all the issues involved and how to resolve them in a cost-effective and sustainable way.

Rhun ap Iorwerth: Will the Minister make a statement on European programmes relating to skills and employment in Ynys Môn?

Lee Waters: People and businesses of Ynys Môn have benefited from a number of EU-funded schemes such as apprenticeships, skills for employers and employees and expanding Môn’s horizons. Since 2007, some 1,400 jobs have been created, over 2,100 people have been helped into employment, and over 9,000 qualifications have been achieved.